Boarding Check-In Form

Boarding Check-In Form

(One Per Pet Per Stay)
Patient/Client

Pet NameOwner First NameOwner Last Name
Phone Number
Format: (000) 000-0000.
Owner Email
example@example.com
Reservation Dates (No Drop-off/Pick-up on Sundays or Holidays)
ESTIMATED PICKUP TIME (Additional night of boarding charged if pickup is after 12PM unless your pet is being bathed/groomed)

:HourMinutesAM/PM Option
DROP-OFF DATE (No Drop-off on Sundays or Holidays)

MonthDayYear
Date
PICKUP DATE/TIME (No Pick-up on Sundays or Holidays)

MonthDayYear
Additional night of boarding charged if pickup is after 12PM unless your pet is being bathed/groomedHourMinutesAM/PM Option
Kennel Sharing - enter name of other pet(s) roommates in same kennel:
Enter name of other pet(s) rooming with the above listed pet.

CLIENT REMINDERS: Please acknowledge the following reminders:

Rows	Confirm Each
Anxious pets may be given TRAZADONE, by doctor, as a calming agent (this drug is very safe and effective)
$ ADDITIONAL NIGHT CHARGED IF PICKUP IS AFTER 12PM. If requested, late checkout would be at 1PM.
DOGS REQUIRE: Canine-Rabies, DA2PP, Bordetella/kennel Cough (6 months), negative fecal test (6 months)
CATS REQUIRE: Feline-Rabies, FVRCP, negative fecal test (6 months)
$ There is an ADDITIONAL HOLIDAY FEE ($) per pet holiday boarding charge for each of the following major holiday days: New Years Eve, New Years Day, July 4th, Memorial Day, Labor Day, Thanksgiving Day, Christmas Eve, Christmas Day.

Feeding Questions:

Rows	Yes/No	Time
Did you bring your pet’s food?
Has your pet eaten today (if Yes, what time)?

ANY MEDICAL CONDITIONS (Ongoing or Recent Issues):
If your pet(s) have any medical condition(s) or current illness (cough, fleas, diarrhea, vomiting, sneezing) then please list above.
YOUR PET'S TEMPERAMENT:
Anything we need to be aware of. For example: aggressive dog, fence jumper, will bite, etc
ANY REQUESTS FOR VETERINARY CARE/ VACCINES DURING STAY?:
Will your pet see the veterinarian for medical reasons while boarding? Please state reason(s).
ANY OTHER REQUESTS?:
Will your pet see the veterinarian for medical reasons while boarding? Please state reason(s).
TENDER LOVING CARE EXTRAS: $ Costs additional so please ask for pricing if needed
HYGIENIC CARE: $ Costs additional so please ask for pricing if needed

Rows	Please describe in detail your grooming request (fill in each row):
Face
Ears
Body
Legs
Tail

MEDICATIONS: Please list all medications and directions:

Please list any belongings that you leave with us at boarding:

UNEXPECTED ILLNESS/ EMERGENCY TREATMENT AUTHORIZATION

All animals boarding or staying at the hospital MUST receive treatment in the case of illness or emergency. Treatment for illness is to prevent further deterioration in health while treatment for emergency is to help
stabilize the patient.

If my pet becomes ill or an emergency arises, I authorize the following maximum treatment expense only as needed at the doctor’s discretion and I trust that the doctor will make the appropriate medical and ethical
decision:

This amount is per pet. Please check one

Rows	$Under $375	$375-$675	$675 or more
Request:

**Every attempt will be made to contact you or any emergency contact that you specify before treatment.

However, if we are unable to reach you (speak to you in person or only receive a voice recording), the health and well‐being of your pet must be our first priority and treatment will be instituted at the doctor's discretion. In severe cases, emergency patients may require ongoing care at a 24-hour or overnight emergency facility**

I have read the boarding requirements and understand the hospitals' policies. I accept full financial responsibility for treatment of my pet should the need arise.
Signature
DateTime
Should be Empty:

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