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UVH Unleashed - Boarding Form
Hi there, please fill out and submit this form so we are ready! One form per pet please.
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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!
YES
NO
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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!
YES
NO
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3
Cat's Name
*
This field is required.
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4
Owner Information
*
This field is required.
First Name
Last Name
###-###-#### Phone Number to reach you while you are gone
Email
Please Select
Call phone
Text phone
Email
Will not be available via phone or email, contact emergency contact
Please Select
Please Select
Call phone
Text phone
Email
Will not be available via phone or email, contact emergency contact
Preferred method to contact while you are gone?
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5
Emergency Contact
*
This field is required.
First Name
Last Name
###-###-#### Emergency Contact Phone Number
Please Select
Yes
No
Please Select
Please Select
Yes
No
Is this person authorized to make medical decisions on your behalf in the event we are not able to reach you?
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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
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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.
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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.
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9
Which suite for your cat
*
This field is required.
Cat Condo - Large open space room with viewing window and cat tree - $48.90 per night, per pet!
Please also select this option if your pet is sharing a condo with another cat in your family. A 10% discount will be applied to all pets who share a condo!
Medical Supervised Stay is a different form, please visit Client Tools page and select that form for that service.
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10
Have you had any concerns while boarding your cat in the past?
*
This field is required.
YES
NO
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11
Please explain those concerns.
How can we make this visit a good experience.
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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.
YES
NO
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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?
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14
Does your pet have a food allergy?
*
This field is required.
YES
NO
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15
If you answered YES that your pet has a food allergy - Please explain the food allergy
Our In house food is Chicken based, If your pet has a food allergy we recommend bringing your own food.
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16
Is your cat on any medications or supplements??
*
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YES
NO
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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.
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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?
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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.
Please Select
Yes
No
Please Select
Please Select
Yes
No
Yes OR No
Please Select
None
Wellness - my pet is getting their routine check-up
Diagnostic - my pet is not well or injured and needs to be assessed by a UVHvet.
Medical Progress -my pet was recently seen and needs their follow up appointment
Surgical or Sedated- my pet will be getting a procedure done or will need to be sedated for an appointment while boarding
Please Select
Please Select
None
Wellness - my pet is getting their routine check-up
Diagnostic - my pet is not well or injured and needs to be assessed by a UVHvet.
Medical Progress -my pet was recently seen and needs their follow up appointment
Surgical or Sedated- my pet will be getting a procedure done or will need to be sedated for an appointment while boarding
What type of appointment?
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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?
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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) - Starting at $95.29
Sanitary Groom (Bath, Sanitary Shave, Paw Pad Trim) - Starting at $69.88
Deluxe Bath (Bath, Pedicure, Anal Gland Expression, and Ear Cleaning) - Starting at $57.17
Pedicure Add On - $27.50
Ear Cleaning Add On - $24.75
No Grooming/Bathing Services Wanted
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22
Say Cheese! Want a picture of your pet while you're away? Just pick how often! $10.10 per pic, per pet!
*
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
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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?
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Please Select
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Pumpkin Dessert Topping $3.93
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Please Select
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Chicken and Rice Topping (1/4 Cup) $4.49
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Please Select
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Tuna Lick Mat $5.50
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Please Select
Please Select
Yes - once
Yes - every other day
Yes- every day
No, thank you
Extra Belly Rubs (If they allow) $10.10
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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!
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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.
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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
Browse Files
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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)
YES
NO
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28
UVHonthego
You must live within a 10 mile radius of UVH to be eligible for Pick up and drop off
Please Select
Pick up only
Drop off only
I need both pick up and drop off
Please Select
Please Select
Pick up only
Drop off only
I need both pick up and drop off
Please select which applies
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29
May we post photos on our social media and/or send you updates via photo/video?
*
This field is required.
YES
NO
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30
UVH Unleashed Agreement
*
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31
Signature
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