Boarding Drop Off Form

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Boarder information collection

Date *

YYYY

Owner Name *

Pet Name *

Emergency Contact Phone Numbers: *

When will you be picking up your pet? *

YYYY

What personal items are being left with your pet? *

If you are leaving your own food, how often and how much does your pet eat?

Is your pet on any medications that will need to be administered while he/she is here boarding? Please list medications, frequency and when you give them (ie at night, with breakfast, etc) *

Do you authorize any and all vaccines required for boarding be performed so that your pet is brought up to date on vaccinations? *

Yes

No (boarding my not be allowed if not up to date on certain vaccines)

Would you like any other services, such as nail trim, anal gland expression, bathing or other performed while your pet is boarding here? If yes, please list.

In the unlikely event that your pet becomes emergently ill and needs immediate treatment, please list the best phone number to contact for authorization of medical care *

We will try diligently to reach you, however, if we are unable to contact anyone for authorization of care, please agree to one of the following: *

Please perform any and all tests and or treatments on my pet; budget is not a concern. I understand payment is due at time of pick up.

Please be conservative on diagnostic test and treatment of my pet. Please do not spend more than $(amount asked next) without discussion and authorization regardless of the circumstances. I understand that payment is due at time of pick up.

Emergency budget (only in case of not being able to contact in emergency situation)

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