Boarding Check-In Form

eastside veterinary associates

1700 NE 44th Street, Newcastle, WA 98056

Phone: (425) 276-4100 Fax: (425) 226-6610

Have you called to schedule your boarding?*

YesNo

Please call Eastside Veterinary Associates at 425-276-4100 to schedule a reservation. Thank you!

Pet's Name*

Pet's Name

Owners Name*

First NameLast Name

Email*

example@example.com

Will you respond to email during your pet's stay?*

YesNo

Phone Number(s)*

Area CodePhone Number

Emergency Contact (Preferably someone not traveling with you)*

First NameLast Name

Emergency Contact Phone Number*

Area CodePhone Number

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

YesNo

Relationship to the owner*

E.g. Spouse, brother, friend, employee

Name of person to pick-up if not the owner (Identification may be required):

First NameLast Name

May we post photos on our social media (Facebook)?*

YesNo

What date do you expect to check in your pet *

MonthDayYearHourMinutesAM/PM Option

What date do you expect to check out your pet *

MonthDayYearHourMinutesAM/PM Option

*Check in and check out times are business hours M-F, and by advance notice on weekends and holidays between 8:30 and 9am or 5:00 pm to 5:30 pm. Please note that check-out must be before noon on weekdays or 5:30p on weekends and holidays to avoid an additional charge for boarding. It is a requirement to leave a credit card on file for any additional incidental charges for all boarding pets.

Please provide a short explanation of your pet’s general personality, any concerns you may have about your pet during boarding, and any special care instructions. *

E.g. food/toy possessiveness, does not like feet touched, has diarrhea when stressed, no running as just had knee surgery, no stairs due to arthritis, etc.

Allergies

Does your pet have any allergies?*

YesNo

Explain

List the allergy and describe the symptoms that occur with the allergy.

Food

When was your pet's last meal?*

DateHourMinutesAM/PM Option

A bland, house kibble will be provided if you did not bring your pet’s food, to be fed twice a day based on your pet’s weight listed on the feeding guide. No canned food is provided. Please note that a sudden diet change can cause your pet to have an upset stomach.

Did you bring your pet's food? *

YesNo

Please specify food(s), amount per serving and servings provided. If you pet's regular diet is something other than kibble or canned food, there will be a special handling fee of $5 (fresh, frozen, home cooked, air dried) to $10 (raw diets) per meal. This fee is for the additional work required to refrigerate, freeze, thaw, heat up, sanitize and disinfect surfaces and clean up.

Type of Food - check all that apply*

Name of Canned Food*

Amount Provided*

Number of Cans

Amount of Can - AM*

Other amount

Amount of Can - PM*

Other amount

Name of Kibble*

Amount Provided*

Please briefly describe container and indicate amount of food. E.g. 1 gallon zip lock bag, 1 gallon sized Tupperware.

Amount of Kibble - AM*

Other amount

Amount of Kibble - PM

Other amount

Other Food Charge*

I agree to $5-10 surcharge EACH FEEDING

Name of Other Type of Food*

Amount Provided*

Please briefly describe container and indicate amount of food. E.g. 1 tube, 1 bag, 1 carton.

Amount of Other Food - AM*

Please be specific. E.g. 2oz, 1/4 cup (provide cup), Use the portion lines on the tube

Amount of Other Food - PM*

Please be specific. E.g. 2oz, 1/4 cup (provide cup), Use the portion lines on the tube

Raw Food Charge*

I agree to $5-10 surcharge EACH FEEDING

Name of Raw Food*

Amount Provided*

Please briefly describe container and indicate amount of food. E.g. 1 tube, 1 bag, 1 carton.

Amount of Raw Food - AM*

Please be specific. E.g. 2oz, 1/4 cup (provide cup), Use the portion lines on the tube

Amount of Raw Food - PM*

Please be specific. E.g. 2oz, 1/4 cup (provide cup), Use the portion lines on the tube

Name of Treats*

Amount Provided*

Please briefly describe container and indicate amount of treats. E.g. Quart zip lock bag, half filled, approximately 20 treats.

Frequency of treats*

When are Treats Given

Number of treats given each time*

Please explain any additional feedings and/or feeding instructions

If a lunch meal is needed, please add the feeding instructions here. If two (or more) family members are boarding together, will they need to be fed separately? If so, how much time should we keep them separated if meal consumption is not immediate? If feeding both dry and canned food, should we mix or keep types of food separate?

Medications

Is your pet on a preventative medication for fleas, intestinal parasite, or heartworm? E.g. Revolution, Trifexis, Sentinel, Interceptor, Bravecto, Credelio, Nexgard.*

YesNo

Please list the name(s) of the medication, and when the last dosage was given. If the medication is to be administered during your pet’s stay, please give instructions on administration. *

E.g. Trifexis 5-10# tablet – Give 1 tablet orally on with a full meal. Please make sure to supply the medication if needed to be given during their stay.

Will your pet need medications or supplements administered during their stay?*

YesNo

Please bring medications in original container with accurate dosing instructions on label. Please write in notes if you are giving medications differently from the labeled directions, otherwise, the labeled directions will be followed.

Once daily medications - please indicate if you are giving it AM or PM.

Twice daily medications are given at 8 am and 6 pm.

Three times a day medications are given at 8 am, 1 pm, and 6 pm.

Administration of up to 4 oral medications are included per day. Additional doses are charged at $5 per dose. Additional charge for special care such as ear cleaning, insulin, tooth brushing, blood glucose monitoring, inhalers, bandage changes or subcutaneous fluid are $10 and up per treatment. Estimates for additional treatments are available upon request prior to check-ins.

Please list all medications and supplements that are to be given while boarding in this order.

Name, strength, and dosage form (e.g. Rimadyl 100 mg tablet)
Quantity, route of administration, and frequency (e.g. Give 1 tablet orally twice daily)
Duration of Therapy (e.g. Entire boarding stay or only if limping seen)
What is the best way to givethe medication? (e.g. In 1 tsp of Peanut Butter)
When was last dose given.(e.g. Morning of check in)

E.g. Rimadyl 100 mg Tablet – Give 1 tablet orally twice daily for the entire boarding stay. Give in 1 teaspoon of peanut butter. Last dose given morning of check in.

Personal Belongings

Each canine suite comes with a sanitized Kuranda bed that provides orthopedic support and off-the-floor comfort, fresh linens, and feeding dishes. Kitty Condos include a litter box, fresh linens, and feeding dishes. We also have measuring scoops and other food prep utensils so no need to supply those either!

In order to maintain the most safe and sanitary environment, personal items will not be accepted. This includes bags, blankets, beds and toys. If they are brought in with your pet, they will be stored in a plastic bag and returned at check out.*

I accept these conditions

Will you be leaving personal belongings for your pet's stay?*

YesNo

Leash

YesNo

Please describe item.

Collar

YesNo

Please describe item.

Harness

YesNo

Please describe item.

Carrier

YesNo

Please describe item.

Are there any other services that you would like for your pet during their stay with us?*

YesNo

Select any services

Bath - DOGS ONLY ($47.50 to $92 depending on weight). Available on weekdays prior to check out. NO baths Saturday or Sunday. LIMIT 1 per stay.Nail Trim ($35.50) LIMIT 1 per stay.Anal Gland Expression ($35.50) LIMIT 1 per stay.Extra Potty Walk(s) - DOGS ONLY ($10/5min)Extra playtime ($17.50/10 mins cats, $23.50/15min dog)Email photo updates ($10/update)

Extra Potty Walk(s). Default is 1 per day. LIMIT 2 per day. (subject to change during peak times)

1 per day2 per dayOther

Extra Playtime(s). Default is 1 per day. LIMIT 2 per day.

1 per day2 per dayOther

Email Photo Update(s). LIMIT 1 per day.

1 per dayOther

Please add detail to service(s) selected or request other services not listed:*

Additional charges will apply for other services. Please specify date(s) and/or time(s) of services. E.g. 'Bath on Thursday. Email photos on first day and last day. Extra potty walk daily at 3pm.'

UPDATED terms and conditions as of 4/6/2019. Please review carefully.

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Boardings are not reserved until you confirm them by phone, please contact Eastside Veterinary Associates at 425-276-4100.

Boarding Check-In Form - Updated 5/30/2023

Care Instructions

Special Services