Pet's Name(s): If multiple pets list them comma separated
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Your Contact Information |
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E-Mail Address :
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Emergency Contact Information |
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Boarding Information |
Coming In Date
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Going Home Date
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Pick up Time (If your pet is getting a bath, please choose pickup time after 2pm)
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Would you like your dog(s) bathed before pick up for an extra charge? (requires later pick up time) Yes (Dogs only) No
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Would you like your pet(s) nails trimmed? Yes No
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Does your pet have a tendency to chew bedding, blankets, towels etc? Yes No
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Would you like your pet to have a bed/blanket? Yes No
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Items being left with your pet:
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We supply comfortable bedding and bowls for your pet. You are welcome to bring special bedding or toys with the understanding that we will do our best to ensure it leaves with your pet but cannot guarantee its return. We will also label all items left with permanent marker, so please do not bring things you do not wish to be labeled or cannot live without. |
Pet's Diet |
Did you bring your pet's food? Yes No
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At what time is your pet's next meal due?
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Special Instructions - Please provide specific details on AM and PM feeding times, amounts, etc
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Medication Information |
Please list any medications to be given while here. Name, Dose, Frequency, Date/Time of Last Dose.
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Please note any additional information regarding medications
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Please list any medical issues you would like addressed. An exam fee may apply
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Misc Information |
Provide any other instructions related to the care or boarding of your pet while it is in our care.
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All animals admitted must be current on their vaccinations. It is the responsibility of the owner to provide accurate vaccination records at the time of check in. If no records are provided, your pet will be vaccinated at the owner's expense.* |
Upon arrival, all pets are treated for fleas with a dose of Capstar. The cost of this is included with the boarding charge. |
I agree Yes No
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If we feel your pet needs medical attention while boarding and we are unable to reach you, do you give Dr. Faludi or Dr. Whitworth permission to treat your pet? |
I agree Yes No
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Signature of authorized agent (person admitting pet)
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