UVH Unleashed Check in Form for Boarding

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Have you called to schedule your boarding?* 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 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

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Your 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

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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. 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?

YESNO

15

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

16

What flea/tick preventions is your cat 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.

17

When did you last administer your cat their flea/tick prevention?* This field is required.

Date

18

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

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 InstructionsSuch as feed separate from house mate, likes to be pet in a certain place, etc.

22

Belongings - are you bringing personal items from home?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 cat 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) *

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

26

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

27

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

Pumpkin Dessert Topping

Chicken and Rice Topping (1/4 Cup)

Kitty Kong

Extra Belly Rubs (If they allow)

28

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!

29

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.

Just type UVH if you use us.

30

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

YESNO

31

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.

32

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

YESNO

33

UVH Unleashed Agreement* This field is required.

34

Signature* This field is required.

Clear

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