UVH Unleashed Check in Form for Boarding

1

Have you called to schedule your pet's boarding stay?* This field is required.No reservation? That's okay. Go ahead and fill out the form. **Please note - 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

Cat's Name* This field is required.

4

Owner Information* This field is required.

First Name

Last Name

###-###-#### Phone Number to reach you while you are gone

Email

Preferred method to contact while you are gone?

5

Emergency Contact* This field is required.

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 cat.* 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 cat.* 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

Which suite for your cat* This field is required.

Cat Condo - Large open space room with viewing window and cat tree

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

Medical Supervised Stay is a different form, please visit Client Tools page and select that form for that service.

10

Have you had any concerns while boarding your cat 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.Unleashed overnight guests will be fed Purina Gastro Intestinal EN for adults; or Purina kitten formula if less than 1 year of age. If you are bringing your pet's food, please provide the food and instructions.

YESNO

13

You answered Yes that you are bringing Food and/or Treats for your pet. Please be as thorough as possible so that we can make sure we follow your instructions!

What Brand of food?

How often do you feed your pet?

How much to feed? (In measurements)

Are you bringing treats? When should we give them, and how much?

14

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

YESNO

15

If you answered YES that your pet has a food allergy - Please explain the food allergyOur In house food is Chicken based, If your pet has a food allergy we recommend bringing your own food.

16

Is your cat on any medications or supplements??* This field is required.

YESNO

17

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.

18

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?

19

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?

20

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 cat is with us?

21

Grooming... we have you covered! Just let us know your choices! *Grooming and deluxe bathes are subject to groomer availability*Just let us know your choices! - *Grooming and Deluxe Bath are subject to groomer availability*

Full Service Grooming (Haircut + Deluxe Bath) *

Sanitary Groom (Bath, Sanitary Shave, Paw Pad Trim)*

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

Pedicure - Add On

Ear Cleaning - Add On

No Grooming/Bathing Services Wanted

22

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

23

Kitty Cat Corner! Let us know what add ons you want for your pet's stay!What can we add on to your Cat's Visit?

Pumpkin Dessert Topping

Chicken and Rice Topping (1/4 Cup)

Tuna Lick Mat

Extra Belly Rubs (If they allow)

24

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 boarding/grooming visit.
Yes, we can update their immunizations when they arrive or perform 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!

25

Medical Record Request - if you pet does not use UVH for veterinary services, what practice may we contact for vaccination records?* 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.

Just type UVH if you use us.

26

If you have your vaccination records on hand, please upload them here!

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

27

UVHonthego - Do you need your cat picked up or dropped off? If you select yes, we will reach out for further scheduling details.* This field is required.This is subject to availability - If you select yes, we will reach out for further scheduling details. (UVHonthego is available Monday - Friday only)

YESNO

28

UVHonthegoYou must live within a 10 mile radius of UVH to be eligible for Pick up and drop off

Please select which applies

29

May we post photos on our social media and/or send you updates via photo/video?* This field is required.

YESNO

30

UVH Unleashed Agreement* This field is required.

31

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.

32

Signature* This field is required.

Clear