UVH Unleashed Check in Form for Boarding

1

Have you called to schedule your pets boarding stay?* This field is required.No reservation? That's okay! Please still fill out this form, but know that filling out this form does not indicate confirmation. One of our Unleashed Team Members will contact you with any questions and to give you confirmation of your reservation. Thank you and we can not wait to play with your pet!

YESNO

2

Has your pet recently experienced any of the following symptoms?* This field is required. - Coughing/Hacking - Sneezing/Wheezing - Vomiting - Diarrhea *Contact us immediately if your pet has experienced any of the above listed symptoms. This may effect your pet's stay with us!

YESNO

3

Dog's Name* This field is required.

4

Owner Information* This field is required.Please list your contact information during your pet's stay.

First Name

Last Name

###-###-#### Phone Number

Email - this is how we send photos of your pet!

Preferred method to contact while you are gone?

5

Emergency Contact* This field is required.In the event you are inaccessible during your pets stay.

First Name

Last Name

###-###-#### Emergency Contact Phone Number

Is this person authorized to make medical decisions on your behalf in the event we are not able to reach you?

6

Person who may be dropping off/picking up your pet if you are not:Owners have sole authorization to approve services and charges UNLESS permission is given by you, the owner. Please know that payment is required at the time of pick up, so please make sure this person is aware we will require payment at pick up. For convenience, you can prepay for your pet's visit. (Identification may be required)

First and Last Name

###-###-#### Phone Number

7

What date and time do you expect to check in your dog.* This field is required.*Unleashed Hours: Monday - Friday 7am - 7pm; Saturday 7am - 4pm; Sundays 9am-11am and 4pm-6pm.

Date

Hour

Minutes

8

What date and time do you expect to check out your dog.* This field is required.Please note that check-outs after 12pm are subject to a later check out charge due to occupancy expectations. *Unleashed Hours: Monday - Friday 7am - 7pm; Saturday 7am - 4pm; Sundays 9am-11am and 4pm-6pm.

Date

Hour

Minutes

9

What type of suite is your pet staying in?* This field is required.Please note if you have NOT booked yet, this is a request and we will confirm based on availability.

VIP Suites 7x7, TV, rooms with a view!

Upscale Suite 5x7; with TV

Classic Suite 7x3

Please also select this option if your pet is sharing a space with another dog in your family.

Medical Supervised Stay - That is another form accessible on out Client Tools page.

10

Have you had any concerns while boarding your dog in the past?* This field is required.

YESNO

11

Please Explain those concerns.How can we make this visit a good experience.

12

Food - Will you bring food and/or treats for your pet?* This field is required.Guests that do NOT bring their own food will be fed Purina Gastro Intestinal EN - Dry for adults; or Purina Puppy Formula - Dry if less than 1 year of age.

YESNO

13

You answered Yes that you are bringing Food and/or Treats for your pet. We need to know the brand of food, how much to feed (in measurements), and how often to feed. AND/OR What type of treats, how many, and when to give them. Please be as thorough as possible so that we can make sure we follow your instructions!

14

Does your pet have a food allergy?* This field is required.

YESNO

15

You answered YES that your pet has a food allergy - Please explain the food allergy

16

What flea/tick preventions is your pet currently taking?* This field is required.UVH Unleashed accepts the following preventions. We will need proof of purchase if not purchased at UVH. *Please note Capstar will be required for any pet with a lapse in prevention or fleas/ticks present at drop off.

Select from the following

17

When did you last administer your pet's flea/tick prevention?* This field is required.

Date

18

Medications - Is your pet on any medications or supplements??

YESNO

19

Medication Instructions:**You must bring the medication in its original container with prescription label that matches your instructions.** Unleashed will not accept medications in daily pill boxes or ziploc bags. We also need instructions if your pet takes medications in a certain way (pill pocket, peanut butter, etc) and you must provide those items. List name of medication(s), how much to be given, and how often and when (AM, Mid day, or PM) Example - (A) Thyrotab 1mg - 1 tab, twice a day (B) Apoquel 5.4mg - 1/2 tab once a day every morning.

20

Refills?Does your pet need any medications, preventions, and/or food refilled while here? If so, do you need any of these administered during your pet's stay?

21

Special Care Instructions Such as leash walks only, carry up stairs, feed separate from house mate, chews blankets, any verbal commands we should know, etc. This helps us give your pet the best experience possible!

22

Belongings - are you bringing personal items from home?If so, please list, describe, and label all items that will be coming with your pet. Ex. blanket, bed, carrier, leash, or collar.

23

Is your pet being seen by a UVHvet during their stay? If so, what type of appointment?* This field is required.Please note that if your pet is having a surgical appointment there will be additional forms to fill out for sedation consent.

Yes OR No

What type of appointment?

24

If your pet does not have a standing appointment but you need them to be seen, please let us know in detail what you need your pet to be seen for. (Excluding wellness)What can we examine while your pet is with us?

25

Grooming...we have you covered!* This field is required.Just let us know your choices! - Grooming and Deluxe Bath are subject to groomer availability

Full Service Grooming (Haircut + Deluxe Bath) *

Deluxe Bath (Bath, Pedicure, Anal Gland Expression, and Ear Cleaning) *

Standard Bath (A Standard Bath is complimentary after 3 nights - select this if you want a qualifying complementary bath or to add a bath if staying less than 3 nights)

Pedicure - Add On

Ear Cleaning - Add On

Anal Gland Expression - Add On

No Grooming/Bathing Services Wanted - Including complimentary bath.

26

In this next section, let us know what add-ons you would like to add to your pet's stay!

27

Say Cheese! Want a picture of your pet while you're away? Just pick how often!* This field is required.This is a one-way email communication and our team will not see responses.

YES - Pictures every day!

YES - Pictures every other day!

YES - Send one picture!

No, thank you

28

DayCare #playwithpurpose - Full day and Half Day available* This field is required.Let your pup have more fun than you while with Unleashed! They can join Daycare for discounted pricing (excluding temp test)! Daycare is open 7 days a week. Your pet must be spayed/neutered to attend. If your pet has not attended daycare, we do require temperament testing to place your dog in the appropriate playgroup. We currently do NOT offer temperament testing on Saturday and Sunday, however, we can get that coordinated before this stay.

Full Day - every day

Half Day - every day

Full Day - every other day

Half Day - every other day

Full Day - once

Half Day - once

No daycare this time

29

Dog Gone Fun! Let us know what add ons you want for your pet's stay!* This field is required.

One on One Fetch

One on One Splash Pad

Extra Belly Rubs

Chicken and Rice Topping (1/4 cup)

Peanut Butter Kong

Pumpkin Dessert Topping

30

IMMUNIZATION PROTOCOL

UVHUnleashed has specific vaccination requirements for boarding/grooming/daycare animals.
"The Why" behind out protocol can be found on our website client tools page via handouts and a Vaccination Education video https://uvhvets.com/client-tools/
We highly recommend that your pet is up to date at least 14 days BEFORE arriving for their visit to Unleashed.
Yes, we can update their immunizations during their stay. However, immunity against illnesses will be more appropriate if your pet has their boosters 2-3 weeks before their visit.

Your pet's health is our top priority!

31

Medical Record Request* This field is required.If your pet does not use UVHvets for veterinarian services, what practice may we contact for vaccination records on your behalf.

Type UVH if you use us.

32

UVHonthego - Do you need your dog picked up or dropped off?This is subject to availability - If you select yes, we will reach out for further scheduling details.

YESNO

33

UVHonthego - If you need UVHonthego for transportation, please select what you are needing...Please note these prices are for a 10 mile radius from UVH, any further mileage may result in an additional mileage fee. OnTheGo operates Monday - Friday only.

34

May we post photos of your pet on our social media or use in marketing?* This field is required.

YESNO

35

UVH Unleashed Agreement * This field is required.We urge you to read this in full. A copy will be sent to you.

36

As a safety precaution, no animals are allowed to have collars on during their stay.

The Unleashed team kindly asks that you remove your pets collar and leash and keep them in your car or at home.

We do not mind keeping them, however, we also do not want to lose something special.

37

Signature* This field is required.

Clear