Boarding Form

1

Your Name

First Name

Last Name

2

Your animal's(s') names.

3

Please confirm your drop off date.

Date

4

Please confirm your pick up date.

Date

5

Please confirm the dates your animal(s) will be boarding.

6

Do you understand and accept responsibility for knowing your dog is required to be current on Rabies, Distemper/Parvo, and Bordetella vaccines? As well as have a current (within the last year) negative fecal and be current on Flea/Tick Prevention? And that cats are required to be current on Rabies and FVRCP vaccines as well as flea and tick prevention?* This field is required.Please know that if proof of vaccination is not provided prior to drop off and you have completed this form, TimberCreek Veterinary Hospital reserves the right to update your animals vaccinations while here and you are assuming any charges associated with that.

YESNO

7

Is your animal a patient at TimberCreek?

YESNO

8

If your pets are not a patient here at TimberCreek, no problem! If we do not already have their vaccination status, please upload them here.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

9

If you do not have them, where are their most current vaccine records located? Please leave the name of the clinic, the phone number, and email address if you know it.* This field is required.This information will be used to contact that veterinary hospital in the event we do not have current records on file. If you believe they are already on file at TimberCreek, please confirm this information regardless for confirmation purposes.

10

What flea/tick prevention do you keep your animal(s) on?

11

When was the last time they received it?

Date

12

Do you need any heartworm or flea/tick prevention given in the facility or to go home? If yes, how many would you like?

13

Are you boarding your cat?

Yes

No

14

Is your cat EVER outdoors?* This field is required.

YESNO

15

Feline Leukemia virus is a retrovirus that affects cats and is one of the most common infectious diseases for them. It can cause a variety of very dangerous health problems (this is LIFE threatening). It is HIGHLY contagious amongst felines. To your knowledge, has your feline ever been tested for Feline Leukemia. Feline Leukemia vaccine is required for indoor/outdoor cats if you answered yes to the previous question, please ensure that is in their records. If it is not, TimberCreek will run a Feline Leukemia test and administer the vaccine.

YESNO

16

Would you like TimberCreek to test for Feline Leukemia?

17

Are you boarding your dog?

No - just a cat.

Yes - 1 dog.

Yes - Multiple dogs.

18

Will we be using personal food or clinic food?There is no charge for clinic food. Personal food is encouraged for dogs with high anxiety or sensitive stomachs.

Personal

Clinic

19

Is your personalized food Hydrolyzed Diet food?

Yes

No

20

Since their food is hydrolyzed, in the event your dog is not eating well, what CAN we give them to help entice them to eat?

21

How much AND how often are they eating at home?Example: 1c twice a day.

22

If your pet is on medication, please list the med(s) below. Please list dosage and instructions as they are on the bottles from your vet.Example: Trazadone - 100mg - 1 tab - Twice Daily

23

What kind of social time does your dog(s) like?Example: If your dog thoroughly enjoys the dog park and situations like that, "Social". If your dog is timid, anxious, gets nervous, they should be "Independent" while here.

Social

Independent

I'm not sure (we can play and find out if this is the case)

Please limit their time to housemates only (only applicable to households with more than 1 dog)

I have multiple dogs that have different preferences

24

If your dogs have different social preferences, you can specify here.For example: Hugo and Couri are social. Ellie is not.

25

If you are boarding more than one dog:Please let us know how your pets get along while at home. If your pets need to be fed separately, that means they need to be boarded in separate runs during their stay but can go out together in the yard. When we feed housemates, we feed in opposite corners of their run at all times.

My pets get along fine and they can be fed/stay in the same run.

My pets must be boarded in separate runs during their stay but can go out to the yard together.

My pets must remain separated the entire time they are here.

Not applicable.

26

Can your dog(s) have bedding?As a standard we do have blankets available for us to use while your dog is here. However, dogs are most often more comfortable with what is familiar so bringing their bed/bedding is highly recommended to keep your dog comfortable.

No - 100% will eat it or destroy it.

Yes - please provide bedding.

Yes - I will bring bedding from home.

27

We offer extra services to pets while boarding with us. Would you like any done?Selecting these means you understand additional services will be provided to your pet during their boarding stay. These are an additional cost and all services must be paid for at the time of pick up.

Nail Trim

Ear Cleaning

Anal Gland Expression

Microchip Placement/Registration

Microchip Recheck and Update

Nutrition Consultation

Bath (NOT AN OPTION FOR CATS)

28

If you have more than one pet, here is a space to specify which animal you want to have which services. EX: Hugo - Ears, Nails, Bath. Ellie - Nails, Bath. Couri - Nails, Bath, Nutrition Consultation

29

Are there any restrictions/medical concerns that will need addressed during your pet's stay?

30

Terms and Conditions* This field is required.Please note clicking the agreement to read it will open another window. You'll need to return to this window to click the agreement.

31

TCVH will try to contact the owner first before administering ANY treatment in the event of an emergency. If the owner cannot be reached, please leave an emergency contact number with a person who is allowed to make medical decisions for your pet in your absence. * This field is required.This should be a name and number that is not the account holders name and number within the TCVH system. EX: Tim Smith - Brother - (999)999-9999

32

In the event that the owner AND the emergency contact cannot be reached, please leave a dollar amount that TCVH has permission to treat your pet with.* This field is required.In the event you will be fairly reachable, think of this as a budget to begin rendering care while we await for a phone call back from you or your emergency contact.

33

What time of day are you anticipating dropping off your animals(s)?* This field is required.Monday - Friday pickups can occur between 6:45am-6pm. Saturdays 8am-12:00pm. Sundays 4pm-5pm.

AM (6:45am-11:59am)

Midday (12pm-4pm)

PM (4pm-6pm)

34

What time of day are you anticipating picking up your animals(s)?* This field is required.Monday - Friday pickups can occur between 6:45am-6pm. Saturdays 8am-12:00pm. Sundays 4pm-5pm.

AM (6:45am-11:59am)

Midday (12pm-4pm)

PM (4pm-6pm)

35

Is this your first time with us?

YESNO

36

How did you hear about us?

37

If it's your first time and you were recommended to us by an existing client, please let us know who it was! You both receive a $20 refer a friend credit.

38

Signing here acknowledges that you have completed the boarding forms to the best of your ability. Upon receipt, you will receive a confirmation text once your forms have been processed on our end. At that time Whitney will verify if there are any missing records.

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