Platinum Boarding Form

Platinum Boarding Form

Five quick minutes that help us make your pet's stay feel like home. Dr. Schiller and Sterling read every answer.
About You
Your name(s)
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you an existing Platinum Veterinary Services client?
Were you referred by Wiggle Butt Academy?
Trainer's name
About Your Pet
Pet's name(s)
Breed
Age
Gender

Other
Is your dog spayed/neutered?
Color/Markings
Upload vaccination records

Cancelof
Vaccination records already on file with Platinum Veterinary Services
Health & Vaccines
Approximate Weight
Your regular veterinary clinic (if not Platinum)
Veterinarian Name
Veterinary Clinic Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Date of Last Rabies Vaccination

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Is your pet current on rabies, DAPP (distemper/parvo), and Bordetella? These are required for boarding — canine influenza and lepto are recommended too.
List any allergies, medications, or medical conditions
Flea/tick prevention — product and date last given
Heartworm prevention — product and date last given
Mobility
Current health conditions

Other
Is there anything you would like us to watch out for?
Any history of biting, guarding, or escaping?
While They're Here

One of the best parts of boarding with your vet: anything your pet is due for can happen while they're here — no separate appointment, no extra trip. Check anything you'd like us to handle, and we'll always confirm the price with you before we do anything.
Care requested during the stay
Tell us more — which vaccines, which medications to refill, how many rehab sessions, anything else we should plan for
Comforts & Quirks
What does your pet LOVE? (favorite games, treats, scratch spots — we take this seriously)
What helps your dog settle? (music, covered crate, quiet, chew)
Potty routine
Comfortable with other dogs?
Comfortable being handled by new people?
Feeding & Care Instructions
How does mealtime work? (food, amounts, times — exactly how they like it at home)
Medications & supplements (name, dose, when — and any tricks that help)
Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Just in Case

This is the part that makes boarding with a veterinary practice different: if your pet becomes ill or injured, Dr. Schiller assesses them right here and calls you. These questions let you tell us in advance how much care to provide before we can reach you. If your pet ever needs more than we can provide on site, we'll transfer to the most appropriate emergency hospital for what's happening — we're fortunate to have several amazing options nearby — and let you know immediately.
Emergency treatment authorization
ER hospital preference (optional)
I understand that if you cannot reach me or my emergency contact within 1 hour in an emergency, I authorize Platinum Veterinary Services to provide the care Dr. Schiller believes is necessary and to transfer my dog to an emergency hospital if needed.
CPR / resuscitation preference
The Stay
Drop-off date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Drop-off time requested
Pick-up date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Pick-up time requested
Anyone else authorized to pick up? (name + phone)
Items you're bringing

Other
The Fine Print
Agreement — please check each
Signature
Should be Empty:

Platinum Boarding Form

About You

About Your Pet

Health & Vaccines

While They're Here

Comforts & Quirks

Feeding & Care Instructions

Emergency Contact Information

Just in Case

The Stay

The Fine Print