Boarding Check-In Form

Give us your preference on feeding.*

Please Feed 1 times per dayPlease Feed 2 times per dayPlease Feed 3 times per day

Type, Brand, Formula/Flavor of Food*
Please make sure all food is in an airtight container and labeled with the brand and formula.
Give us your preference on feeding.*

Please Feed 1 times per dayPlease Feed 2 times per dayPlease Feed 3 times per day
How many cans/cups per feeding?*
Additional Feeding Instructions

Treats*

I will provide treats for my pet.My pet is okay to receive treats from MVVHC (We use treats to get pets in an out of kennels and rewards for good behavior).Please do not feed my pet any treats.
If you are providing treats please list what kind and how you would like them given.
Treats need to be in an airtight container with a label of the brand and formula of the treats.
Will any medication need to be administered during your pet's stay?*

YesNo

Medications

Due to federal law, all medications need to be in their original container with the original prescription label on the bottle. All prescription, supplements, vitamins, etc. need to be in the original packaging. Again, due to federal and state laws, we cannot have unlabeled products in our building.
Please list each medication and administration directions on a separate line.

Emergency Contacts

Your emergency contact(s) can be yourself, but must be reachable by phone. You also give any listed contact the authorization to make treatment and/or financial decisions for your pet in emergency situations while your pet is boarding with us.
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Name

First NameLast Name
Phone Number

Area CodePhone Number
Medical/Illness Directions

At Mountain View Veterinary Health Center (MVVHC), we are focused on providing a medically safe and emotionally fear-free experience for your pet. We want your pet to feel safe and secure in our care.
In order to provide this, we have set the following policy: If our veterinarian determines that your pet is anxious and is unable to enjoy their stay, they will review your pet’s medical record and consider prescribing anti-anxiety medications to help decrease fear and anxiety. If needed, do you authorize us to administer anti-anxiety medications? We will contact you if charges are $25 or more.*

Yes, please administer anti-anxiety medications as needed. I understand that I will be financially responsible and that I will not be contacted if charges are less than $25.No, please DO NOT administer anti-anxiety medications without contacting me and receiving authorization.
Sometimes boarding pets do not eat as well as they do at home. In order to address this concern, we will sometimes administer canned baby food or canned wet food in order to stimulate appetite. If your pet is having issues eating, do you authorize us to offer canned food as an appetite stimulant? We will contact you if charges are $15 or more.*

Yes, please offer baby food or canned wet food to my pet as an appetite stimulant if they are not eating well. I understand that I will be financially responsible and that I will not be contacted if charges are less than $15.No, please DO NOT offer an appetite stimulant without contacting me and receiving authorization.
In the case of medical concern or illness, we will attempt to contact you or your emergency contact at the numbers provided as soon as possible. In the event that medical care is needed for your pet, please give us guidance on how you would like us to proceed.*

I authorize Mountain View Veterinary Health Center to perform whatever treatments are necessary and accept full financial responsibility for all charges related to the treatment of my pet.I authorize up to a specified amount in medical care during my pet's stay (specify on next page).DO NOT administer any medical treatment until authorization is given, unless denying treatment prolongs suffering to my pet and I cannot be contacted within 1 hour. I then authorize Mountain View Veterinary Health Center to treat my pet according to the on-duty veterinarian's recommendations and the Emergency Directive (on next page) up to and including euthanasia. I will accept full financial responsibility for all charges incurred.

Please do not exceed this dollar amount in treatments:

Emergency Directive
In the case of a major medical emergency please give us guidance.*

Should unexpected life-saving emergency care be required the hospital staff HAS my permission to provide life-saving treatment and I understand additional fees will incur and agree to pay for such service, fully understanding that my pet may not survive life-saving procedures or may have irreparable damage. Life-saving emergency care will be limited to the financial choices made on the Medical/Illness direction given previously.Should unexpected life-saving emergency care be required the hospital staff DOES NOT HAVE my permission to provide life-saving treatment. Please do not resuscitate my pet.
Pick Up Authorization

For the safety of your pet we cannot release them to anyone not named as an owner on your account or authorized below. Please list any people who are authorized to pick up your animal. Please keep in mind payment is required at the time of pick up if not taken beforehand.
Name

First NameLast Name
Phone Number

Area CodePhone Number
Name

First NameLast Name
Phone Number

Area CodePhone Number
You're more than welcome to bring personal belongings for your pet during their stay. We will record these on this form at check-in. All items must be labeled with your last name in permanent form. We are not responsible for lost or damaged items and do not guarantee the return of any personal belongings.

Please remember your pet must be up-to-date on their veterinary exam, veterinary administered vaccines, and intestinal parasite control according to our hospital policy and the Boarding Policy Agreement before your pet's stay.
Please sign agreeing to information and choices on this form. *

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Boarding Check-In Form - Providence

Food

Medications

Emergency Contacts

Medical/Illness Directions

Emergency Directive

Pick Up Authorization