BOARDING FORM

BOARDING FORM
Date In:

Month Day Year
Date
Date Out:

Month Day Year
Date
Pick Up Time:
Name

First Name Owner Last Name
Phone Number:
Pet Name:
Emergency Contact:
Phone:
Please check Yes or No (Additional Fees apply):

Do you want a bath while boarding?
YES
NO
Regular Bath
Bath Plus
Do you wish to receive a picture of your pet(s) while boarding?

Please Note: For the safety of your pet and others that are boarding with us, we require that all pets be current on their vaccinations, as well as, flea and tick prevention. For dogs, this is a current Rabies, Distemper/Parvo, Bordetella and fecal. For cats, this is a current FVRCP and Rabies.
Y
N
/ N

Is your pet current of heartworm/ flea/ tick prevention? Y
Vaccines Requested:
Rabies
DAP
Lyme
Leptospirosis
Bordetella
Influenza
Heartworm test
Fecal
FVRCP
Feline Leukemia
HW/Flea Prevention
Sometimes a pet objects to us trying to help him/her and becomes irritated enough so that we cannot accomplish our goal. Should this occur, may we sedate your

pet to complete the work? If so, there will be an additional fee for sedation.
(Please initial) May we sedate: YES

NO:
NO:
Special Food or Medication:
Time Fed/Medicated:
IN THE EVENT OF AN EMERGENCY DURING MY PET(S)’s STAY: please initial

Yes/No any and all diagnostic tests, treatments and emergency surgery necessary for the well-being of my pet(s I accept full financial responsibility for all fees related to the treatment of my pet(s

If you cannot contact me or my authorized agent in the event of an emergency; please treat my pet(s) as needed and do
Additional Notes/ Comments:
Client Signature:

Clear
Date:

Month Day Year
Date
THANK YOU FOR CHOOSING ANIMAL MEDICAL CENTER FOR YOUR PETS’ VETERINARY NEEDS!
Staff initials
Should be Empty:

BOARDING FORM

Vaccines Requested:

Time Fed/Medicated:

THANK YOU FOR CHOOSING ANIMAL MEDICAL CENTER FOR YOUR PETS’ VETERINARY NEEDS!