EasTex Veterinary Clinic
Pets Name: ______________________________
Please provide the following information, so we may take the very best care of your pet!!
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Has there been any recent sneezing, coughing, vomiting, diarrhea, or any other changes in
health? YES or NO
If so, please explain____________________________________________________________________
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Is your pet on a SPECIAL Diet? YES or NO If so, what diet ____________________________
Is your pet fed ONCE or TWICE daily? _______
How much does your pet eat per meal? __________ (8 oz cup)
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Does your pet take any medications? YES or NO
If so, please list dosage information and instructions for each medication. ____________________
____________________________________________________________________________________
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Please list any additional procedures to be done while your pet is boarding (baths, surgical or
medical procedures, etc.). ___________________________________________________________
*We attempt to minimize your pet’s exposure to fleas at our facility. We recommend your pet
receive flea prevention on a regular basis. If obvious fleas are found on your pet while staying with
us, we may give a dose of Capstar ($5.00 per dose). Capstar is a very safe oral medication that will
leave no pesticide residue on your pet and will kill any fleas on your pet for 48 hours.
REQUIREMENTS FOR BOARDING
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All animals must be current on all vaccinations. (Rabies, Combo, Bordetella)
All animals must be free of external parasites (ex. ticks, fleas, etc.), or they will be treated at owner's expense.
A call will be made to owner prior to medical treatment.
EasTex Vet Clinic has my permission to do whatever is necessary should an emergency arise.
If a tranquilizer is necessary for treatment or handling, EasTex Vet Clinic has my permission to administer such medication.
Pets may be picked up before noon or after 3 PM Monday through Friday and before noon on Saturday. No exceptions .
I have read the boarding requirements and understand the hospitals policies.
Signature: _____________________________________________________Date:_________________
Telephone Number: _____________________________________________