Name *

Email *

Boarding For

Client #

Boarding Date

Arrival Date *

Departure Date/Time *

EMERGENCY PHONE NUMBERS:

Where you can be reached *

ALL PETS NEED VACCINATIONS YEARLY. IS YOUR PET CURRENT ON VACC.? *

Yes
No

Vaccinations will be updated if there is no proof they are current. If given elsewhere, please provide the name and number of the clinic:

We recommend a Kennel Cough vaccine for dogs. This vaccine lasts 1 year. Would you like it done today? The cost is $33.00. *

Yes
No

MEDICAL AND EMERGENCY CARE

When your pet arrives, it will be checked by an assistant for any obvious problems. If fleas or ticks are found, they will be treated immediately at a cost of $34.00. If your pet becomes ill, we will provide medical care unless you have specifically instructed us otherwise. If the care is extended, we will call the emergency numbers before proceeding beyond $100.00 in medical services. If the owner cannot be reached, we will continue care unless you instruct us not to ahead of time. If you want to leave a budget limit on medical care, or special instructions, please do so here:

Transfer to a 24 hour facility would require an approved credit card and expiration date with 3-digit code on the back of the card. *

I have read and understand

Please list any medications your pet needs administered while here.

SERVICES WHILE HERE

Are there any healthy issues or concerns to be addressed while boarding?

We want all pets to go home clean, so we deduct 10% off the bath price for each day of boarding. For example, a 5-day stay would be 50% off. Do you want your pet bathed? YES NO *

Yes
No

ITEMS BROUGHT WITH YOUR PET:

Any items brought to be left with your pet such as a towel or toy can be easily soiled or damaged. Dirty towels are washed with other towels and finding the same towel is sometimes difficult. We cannot guarantee safe return of such item. It is helpful if you label these items with a permanent marker.

Please sign acknowledging you have read this form & agree to the terms stated. *

Date *

South Arlington Animal Clinic

Boarding Form

Boarding Form

Boarding Date

EMERGENCY PHONE NUMBERS:

MEDICAL AND EMERGENCY CARE

SERVICES WHILE HERE

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