Boarding Check-In Form

Give us your preference on feeding.

Type, Brand, Formula/Flavor of Food
Please make sure all food is in an airtight container and labeled with the brand and formula.
Give us your preference on feeding.
How many cans/cups per feeding?
Additional Feeding Instructions

Treats
If you are providing treats please list what kind and how you would like them given.
Treats need to be in an airtight container with a label of the brand and formula of the treats.
Will any medication need to be administered during your pet's stay?

Medications

Due to federal law, all medications need to be in their original container with the original prescription label on the bottle. All prescription, supplements, vitamins, etc. need to be in the original packaging. Again, due to federal and state laws, we cannot have unlabeled products in our building.
Please list each medication and administration directions on a separate line.

Emergency Contacts

Your emergency contact(s) can be yourself, but must be reachable by phone. You also give any listed contact the authorization to make treatment and/or financial decisions for your pet in emergency situations while your pet is boarding with us.
Name

First NameLast Name
Phone Number

Area CodePhone Number
Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical/Illness Directions

At Mountain View Veterinary Health Center (MVVHC), we are focused on providing a medically safe and emotionally fear-free experience for your pet. We want your pet to feel safe and secure in our care.
In order to provide this, we have set the following policy: If our veterinarian determines that your pet is anxious and is unable to enjoy their stay, they will review your pet’s medical record and consider prescribing anti-anxiety medications to help decrease fear and anxiety. If needed, do you authorize us to administer anti-anxiety medications? We will contact you if charges are $25 or more.
Sometimes boarding pets do not eat as well as they do at home. In order to address this concern, we will sometimes administer canned baby food or canned wet food in order to stimulate appetite. If your pet is having issues eating, do you authorize us to offer canned food as an appetite stimulant? We will contact you if charges are $15 or more.
In the case of medical concern or illness, we will attempt to contact you or your emergency contact at the numbers provided as soon as possible. In the event that medical care is needed for your pet, please give us guidance on how you would like us to proceed.

DO NOT administer any medical treatment until authorization is given, unless denying treatment prolongs suffering to my pet and I cannot be contacted within 1 hour. I then authorize Mountain View Veterinary Health Center to treat my pet according to the on-duty veterinarian's recommendations and the Emergency Directive (on next page) up to and including euthanasia. I will accept full financial responsibility for all charges incurred.

Please do not exceed this dollar amount in treatments:

Emergency Directive
In the case of a major medical emergency please give us guidance.

Should unexpected life-saving emergency care be required the hospital staff HAS my permission to provide life-saving treatment and I understand additional fees will incur and agree to pay for such service, fully understanding that my pet may not survive life-saving procedures or may have irreparable damage. Life-saving emergency care will be limited to the financial choices made on the Medical/Illness direction given previously.
Pick Up Authorization

For the safety of your pet we cannot release them to anyone not named as an owner on your account or authorized below. Please list any people who are authorized to pick up your animal. Please keep in mind payment is required at the time of pick up if not taken beforehand.
Name

First NameLast Name
Phone Number

Area CodePhone Number
Name

First NameLast Name
Phone Number

Area CodePhone Number
You're more than welcome to bring personal belongings for your pet during their stay. We will record these on this form at check-in. All items must be labeled with your last name in permanent form. We are not responsible for lost or damaged items and do not guarantee the return of any personal belongings.

Please remember your pet must be up-to-date on their veterinary exam, veterinary administered vaccines, and intestinal parasite control according to our hospital policy and the Boarding Policy Agreement before your pet's stay.
Please sign agreeing to information and choices on this form.
Should be Empty:

Boarding Check-In Form - Providence

Food

Medications

Emergency Contacts

Medical/Illness Directions

Emergency Directive

Pick Up Authorization