Boarding Form

East Poplarville Veterinary Clinic, PA Boarding Services
Drop Off Date*

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Pick Up Date*

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Calculation
Comp Bath

Comp Bath

Client Information
Name*
Phone*
Address*
Emergency Contact
Phone

Boarding Information
Current Heartworm Prevention:*
If Other:
Please specify
Current Flea Prevention:*
If Other:
Please specify
Up to Date on prevention and vaccinations?*

YesNo
Feeding*
We feed Science Diet Sensitive Stomach & Skin according to reccomended feeding instructions from Hill's to all boarders if "Provided" is selected
If Own, please list instructions
Medications Needed:*
Please list name, dosage, and instructions for all medications/vitamins/supplements needs for your pet(s) during their stay
Items left with pet*
* I understand that any items left behind with pet may be destroyed, lost, or damaged and that they may not be returned at pickup.
Special Instructions
Please list any special instructions you have for your pet(s) or information you think we will need
Grooming Services Requested
Any stay of 5 nights or more will include a complimentary bath and nail trim
- You are verifying that you are the owner or agent for the animal(s) above and that you have the authority to execute this consent.
- You authorize the veterinarian to do whatever is necessary should an emergency situation arise, to include tranquilization as required.
- You agree to pick up your pet within 5 days of the discharge date, and your pet may be considered abandoned if you do not. Failure to recover your pet will authorize us to dispose of your pet as deemed professionally necessary but this does not relieve you of financial responsibilities.
- Responsible precaution will be used against injury, escape, or death. The clinic and/or staff will not be held liable for problems that develop provided reasonable care and precautions are followed. You understand that any problem that develops with your pet will be treated as deemed best by the staff veterinarians and you assume full responsibility for the treatment involved. It is thoroughly understood that you assume all risks.
- Pets released ONLY during normal office hours. Check out is by 5:00pm Mon-Fri and Sat by 12 noon.
Responsible Party Signature*

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Date*

MonthDayYear
Date
Client Boarding Agreement

Current Vaccinations

For the safety of all our guests, all animals must be current on all vaccinations. These Vaccinations include:

Dogs: DA2PL4+P, Kennel Cough, and Rabies

Cats: FVRCP, Feline Leukemia, and Rabies.

Vaccinations must have been administered by a veterinarian. If your pet(s) vaccinations were administered by another veterinarian, we must have a copy of the record or proof of vaccination for our records. For the safety and health of your pet, no exceptions will be made.
Initial:*

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FLEAS AND TICKS

Flea infestation can lead to tapeworm and other health problems. If fleas are found during the duration of your pet(s) stay, we will give your pet an oral tablet called a Capstar for an additional charge added to your bill. The pill will kill the fleas on your pet as well as keeping our facility flea-free. Ticks found will be removed for an ad- ditional charge. Please remember that parasites are a hazard to your pet as well as humans.
Initial:*

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AGGRESSIVE OR DANGEROUS PETS

Owners must inform us if your pet bites, has bitten, or is aggressive. We reserve the right to refuse or stop services for your pet at any time before or after the duration of your pet(s) boarding, and charge an aggressive dog fee in addition to the regular boarding/grooming charge.
Initial:*

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HEALTH AND MEDICAL

If at any time your pet should need immediate Veterinary treatment during their stay, we will do our best to contact you first, and then proceed with treatment if not able to get in touch. You have disclosed any and all known medical history/health conditions
Initial:*

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