Boarding Admission Form

Client Name

Client Phone Number

Patient Name

Emergency Contact Person Name and Phone Number

Pick up Date and Time: (Patients are admitted and discharged 8:00am-5:45pm Monday thru Wed, 8am-6:45pm Thur and 8am-3:45pm Friday, Closed daily from 12pm-1:00pm)

Special Instructions: If your pet requires continual Medication, we will be glad to administer it for a charge. Please list medication(s) below, dosage and the time administered.

If your pet requires a special prescription diet you may bring it for us to feed during his/her stay or we can feed your pet our standard of Hill's Science Diet Sensitive Stomach and Skin dry kibble. Please tell us what diet you have brought for us to feed (if applicable), frequency, and quantity:

Due to space limitations and disinfecting purposes we can only accept a collar, leash, food and medications for your pet; we will not be responsible for any lost or damaged items; thank you for your compliance. Please describe Collar and Leash.

Please List Any Special Request:

Please select any additional services you wish to be performed while your pet is boarding: *If your pet is scheduled for a bath, please call prior to pick up to ensure that he/she is ready. Please Note:

1. All vaccinations must be up to date or they will be administered upon admission for boarding and charged accordingly; all dogs must be vaccinated for bordetella bi-annually.
2. If your pet has internal or external parasites, they will be treated and you will be charged accordingly.
3. If your pet becomes ill while boarding, every attempt will be made to notify you or the above listed emergency contact. However, because your pet's health and safety is important to us and our main priority, should any problems arise, medical treatment will be administered and you will be charged accordingly.
4. We make every attempt to keep your pets as clean as possible. However, in a kennel environment, soiling of a pet may occur. If this should happen, your pet will be bathed and you will be charged accordingly.
5. All pets must be picked up before noon or an additional day of boarding will be charged.
6. Any pet dropped off after 1:00pm and will require an exam or vaccines, will not be available for pick up until after 1:00pm on the scheduled day of pickup to ensure that DVM has the required time to fully examine and treat your pet.

Yes, I understand

Monday	8:00 am	6:00 pm
Tuesday	8:00 am	6:00 pm
Wednesday	8:00 am	6:00 pm
Thursday	7:00 am	7:00 pm
Friday	8:00 am	4:00 pm
Saturday	Closed
Sunday	Closed