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Owner's Name

Phone Number

Email

Primary Emergency Contact

Primary Emergency Phone

Secondary Emergency Contact

Secondary Emergency Phone

Social Media Permission

Yes, please use my pet’s photo for social media
No, please do not use my pet’s photo for social media

Pet Social Media Tags

Drop Off Date

Pick Up Date

Arrival

Do you need a carrier / will your pet be leashed?

Yes, my pet will be in a carrier or on a leash at arrival.
No, I will need a leash or carrier for my pet.

Pet's Name

Behavior - Other: Please list & describe

List of Items Brought:

(including leash/collar/toys/bowls, etc.)

Would you like your pet to eat the clinic diet or will your provide your pet with their own diet?

Clinic Diet
Owners Diet

Please list any food allergies your pet may have

Please list the food that will be provided.

Please be sure to specify the name of the food, how much to feed, and how often to feed.

Medications

No medication required
I brought my pet's medication
I need to fill medication for my pet while boarding

List Medications

Please list any medications your pet may need to take including name(s), dosage(s), frequency, and schedule.

Name of Medication

How much of the medication is to be given?

How often is the medication to be administered?

When was the last dose administered & when is the next dose due?

Second Medication to List?

Name of 2nd Medication

How much of the medication is to be given?

How often is the medication to be administered?

When was the last dose administered & when is the next dose due?

Third Medication to List?

Name of 3rd Medication

How much of the medication is to be given?

How often is the medication to be administered?

When was the last dose administered & when is the next dose due?

Service: Bath

Baths will be performed on your pet's last boarding day, and your pet will be ready to go after 2:00pm. A text message will be sent when your pet is ready.

We can also accommodate an earlier bath day if early pick up is needed though, just let us know!

Please list your questions / concerns:

Please list the services you are interested in for your pet:

Do you have any other pets being boarded?

Second Pet's Name

Behavior - Other: Please list & describe

List of Items Brought:

(including leash/collar/toys/bowls, etc.)

Would you like your pet to eat the clinic diet or will your provide your pet with their own diet?

Clinic Diet
Owners Diet

Please list any food allergies your pet may have

Please list the food that will be provided.

Please be sure to specify the name of the food, how much to feed, and how often to feed.

Second Pet Medications

No medication required
I brought my pet's medication
I need to fill medication for my pet while boarding

List Second Pet's Medications

Please list any medications your pet may need to take including name(s), dosage(s), frequency, and schedule.

Name of Medication

How much of the medication is to be given?

How often is the medication to be administered?

When was the last dose administered & when is the next dose due?

Second Medication to List?

Name of Second Medication

How much of the medication is to be given?

How often is the medication to be administered?

When was the last dose administered & when is the next dose due?

Third Medication to List?

Name of Third Medication?

How much of the medication is to be given?

How often is the medication to be administered?

When was the last dose administered & when is the next dose due?

Service: Bath

Baths will be performed on your pet's last boarding day, and your pet will be ready to go after 2:00pm. A text message will be sent when your pet is ready.

We can also accommodate an earlier bath day if early pick up is needed though, just let us know!

Please list your questions / concerns:

Please list the services you are interested in for your pet:

Would your pets like to board together or separately (This is only with your permission)

Together
Separately

Pet(s) Boarding With Us

Are they exhibiting any symptoms such as coughing, sneezing, nasal discharge, vomiting, diarrhea, lethargy, decreased appetite, or reluctance to eat?

No
Yes (Please call our clinic to discuss, so we can resolve prior to boarding, and hopefully prevent any spread of sickness prior to being in the kennel.)

Boarding Disclosure

We give Capstar to all pets staying with us regardless of whether we see fleas.
All pets require a negative fecal within the 6 months prior to their stay.
All pets are required to be fully up to date on vaccines.
All dogs are required to provide proof of monthly heartworm prevention use or a negative heartworm test within 30 days of boarding.

Boarding Release

In the event my pet becomes ill, I authorize the attending veterinarian to administer treatment as is considered therapeutically and/or diagnostically necessary. I also consent to the administration of such anesthetics, as are necessary and surgical procedures of an emergency nature. I understand that the Doctors or Staff will make every effort to contact me prior to any treatment or medication over a cost of $100.00 and or surgical care of major medical emergency.

I agree to pay for any and all vaccinations that are deemed necessary for my pets stay.
If a medical problem is discovered during my pets stay, I understand that care will be provided I and agree to pay for all necessary treatment.
I agree to pay for flea treatment if fleas or flea dirt are found on my pet on admission or during my pets stay.
I understand that boarding rates are charged by the night.
I agree to pay in full for all services rendered at the time of discharge.
I understand that there are no pick ups outside of the Normal Business hours.

Acceptance

I acknowledge and agree to the terms and conditions of service