Boarding Release Form

IMPORTANT!

To reserve your boarding please call us as 815-786-2103 to check availability.
Boarding Drop Off Hours

Our boarding drop off hours are from 9am - 3pm Monday-Friday and Saturday from 9am-11am. If you have a special check-in time request please call 815-786-2103 to speak to one of our client service representatives.
Boarding Release Form

I, hereby consent and authorize my pet to be boarded at the Sandwich Veterinary Hospital. In the event of an illness or injury, the doctors will make an attempt to contact the person listed below at the phone number given. If contact cannot be made, the doctor will begin treatment as necessary and desirable in their professional judgement. I accept and assume total financial responsibility for any and all services rendered by the hospital, its staff or employees in the treatment of the above described animal and agree to pay the fees at the time of my pet's discharge. If my animal enters the hospital with fleas and/or ticks, they will be treated for fleas with a preventative and/or Capstar to kill fleas at my expense. If my animal is not claimed on or before the expected return date designated below, written notice will be mailed to the address on file to remove the animal(s). Five days after such written notice, the animal(s) will be considered abandoned. Pets are required to be fully vaccinated (dog: Rabies, DHLPP, Bordetella; cat: Rabies, FVRCP) and have a current negative internal parasite screening.
Owner's Name

First NameLast Name
Pet's Name
Owner Contact Info
Contact Person

First NameLast Name
Contact Phone Number

Area CodePhone Number
Contact Phone Number Type
Alternate Phone Number

Area CodePhone Number
Contact Phone Number Type
Email
example@example.com
Arrival Date

MonthDayYear
First day of boarding
Return Date

MonthDayYear
Day checking out
Signature
Feeding

You may bring your pet's own diet. If you do not bring your pet's diet we will feed Hill's Science Diet Sensitive Skin and Stomach.
Are you bringing your pet's food?
Name of Food(s)
Amount of DRY fed
Amount of CANNED fed
Number of times fed per day
Does your pet have food allergies?
Bathing/Nail Trim

Please check the appropriate box for the optional services you would like. We reserve the right to decline grooming services based on pet's behavior in kennels. Boarding can be a stressful time. We do not want to add any extra stress.
Please select your after boarding bath and nail trim option:
Toys/Bedding

Upon request we will provide your pet with the following options, they all get extra pets and love regardless! We request that you do not bring these items from home, we don't want to lose your pet's favorite blanket!
Please select your toy/blanket preference:
By checking this box you confirm that it is ok to leave your pet with a blanket unsupervised, please do not check yes if your pet has any history or thoughts of chewing on these, that surgery is expensive!
Medical Information
The staff at Sandwich Veterinary Hospital will make every effort to prevent complications arising from your pet’s stay while in our care.

While it is very rare, there is a small risk that a pet may experience respiratory and/or cardiac arrest during their stay—most often in those with serious underlying medical conditions such as heart disease, organ dysfunction, cancer, or advanced age. For this reason, we require a CPR directive for all pets boarding with us to ensure we can act according to your wishes in the unlikely event of an emergency.
Please select your DNR preference
Signature for DNR selection
Is your pet on any medication that will need to be administered while boarding? (Med administration is $6 per day)
Please list the medications below and include the directions (how much and how often to give) and the last time the medication was given
Does your pet have any allergies?
Please list allergies
Can your pet have our treats?
Should be Empty:

IMPORTANT!

Boarding Drop Off Hours

Boarding Release Form

Owner Contact Info

Feeding

Bathing/Nail Trim

Toys/Bedding

Medical Information