Superior Animal Hospital & Boarding Suites Boarding - New Client/Patient Information Form

New Boarding Client/Patient Information Registration
THANK YOU for choosing Superior Boarding Suites! Our facility will allow your pet to be as comfortable as possible while you are away. Please feel free to contact us for a tour of our facilities at any time.
Client Information
Owner's Name*

First NameLast Name
Spouse/Co-Owner's Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Owner's Phone #*
Please enter a valid phone number.
Spouse/Co-Owner's Phone #
Please enter a valid phone number.
Pet Information
Pet's Name*
Sex*

MaleFemale
Spayed/Neutered*

YesNo
Age*
Breed*
Color*
Current Medical Conditions: Please provide information on any medical conditions your pet(s) currently has. Medical treatment history from your veterinarian is also greatly appreciated.
Misc. Information
How did you hear about us?*

Hospital Sign/LocationOnline SearchFacebookAEVS/EmergencyYellow PagesAnimal AlliesHumane Society of Douglas CountyReferralOther
If referral, who can we thank?*
Important Medical Information:

We require dogs to be current on Rabies, Distemper/Parvo and Bordetella vaccines as well as have a negative fecal sample in the last year. We require cats to be current on rabies, Distemper Combo and Leukemia vaccines as well as have a negative fecal sample in the last year.

**We require documented proof of your pet's vaccines before boarding**
If you do not provide vaccination documentation, your pet may not be able to stay with us.

Any pets found with parasites (intestinal worms, fleas, ticks, mites, etc) will be treated at the owner's expense.

If your pet is on any medication(s), please bring them in their original container, preferably with a prescription label. *there is a $1 per day charge to administer oral or topical medications and a $3 per day charge to administer injections, including insulin.
Signature*

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Today's Date*

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New Boarding Client/Patient Information Registration

Client Information

Pet Information

Misc. Information