Coastal Animal Medical Center
6010 111th St. E.
Bradenton, FL 34211
941-747-7107
Boarding Instruction Form
Date: _______________________
Client Name: _______________________
Telephone: _______________________
Arrival Date: _________________________
Departure Date: _______________________
Patient Names: _____________________________________
Person Picking Up Pet(s): _____________________________
Departure Time: ____________________________________
Instructions for Each Pet:
Medications to be Given:
Feeding Instructions:
Special Instructions:
Belongings brought with pets:
Boarding Information
Standard boarding includes the room, 3 outside play times each day accompanied by one of our team members (dogs
only), administering oral medicines up to twice daily. In order for pets to board together, they must be able to go
outside together with our team member and eat together without supervision. Any extra services will be charged as
indicated below. (Check a box for the size accommodations your pet(s) have reserved)
Boarding Rates per night
Cat Condo
Small Suite
Medium Suite
Large Suite
First Pet
$18
$35
$45
$55
Additional Pet Same Suite
$ 9.00
$17.50
$22.50
$27.50
The boarding suites are furnished with raised beds with soft bedding. The replacement cost if your dog chews the
bedding is $12 for blankets and $8.00 for sheets. If you think your pet may chew these items, it is best to remove them
from the suite. If your dog does chew and/or eat the bedding, CAMC is not responsible for any injury or illness that may
occur. Please circle if these items should remain or be removed during the visit.
REMAIN
REMOVE
I authorize and agree to pay for the following extras while my pet is boarding: (circle one on each line)
Extra Potty Break (5 min)($4.00 each per suite)
None 1 Daily 2 Daily
Hugs and Kisses Session (5 min) ($4.00 each per suite)
None 1 Daily 2 Daily
Frozen Probiotic Treat(s)(up to 50# $1.25 per day Over 50# $2.50 per day)
None 1 Daily
Meds given more than twice daily or any injection $3.00 daily
Bath by weight < 25# - $25, 26-50# - $35, 51-80# - $40, 81-125# - $45, >125#- $55 (Pets receiving
a bath could be bathed the evening before discharge) (We bathe for cleanliness only. We do not
brush or blow dry)
Ear Cleaning $27.80
Pedicure $12.80
Health Information
My pet is current on flea prevention?
yes
no
What brand of flea prevention was given?
My pet has
has not
experienced any allergic reaction to medicine or vaccinations? If so then explain:
My Pet's vaccinations are current
are not current
. If not current, please give all required vaccinations
I would like my pet to be examined by a vet while boarding:
Reason for veterinary visit:
$49 non PPC;
.
Free for PPC member.
I would like my pet to receive the following preventive care items:
Dog Preventive Care
Cat Preventive Care
Fecal Exam
$27.95
Fecal Exam
Heartworm Test
$39.80
Aids/Leukemia Test
Distemper Vaccination
$21.00
Distemper Vaccination
Leptospirosis Vaccination $20.00
Feline Leukemia Vaccination
Lyme Vaccination
$34.90
Rabies Vaccination
Rabies Vaccination
$18.00
Manatee County License
Manatee County License $17.00
Rattlesnake Vaccination
$31.00
Bordatella Injectible
$17.65
Microchip
$38.00
$27.95
$48.51
$20.00
$24.00
$18.00
$17.00
REQUIREMENTS FOR BOARDING







All animals must be current on vaccinations: Distemper, rabies, bordetella (dogs); Distemper, rabies (cats)
All animals must have been treated with a flea medicine within the past month or they will be treated here at
owner's expense.
We allow our clients to bring items such as toys and bedding from home to make their pets feel comfortable while
they are here. There is a risk your pet may chew or soil these items. Coastal Animal Medical Center is not
responsible for these items or for any injury they may cause your pet
We take all boarding dogs outside for playtime in our fenced yard. When they play outdoors, there is always a risk of
bug bites, bee stings, and other injuries. Coastal Animal Medical Center is not liable for any such injury.
Coastal Animal Medical Center has my permission to do whatever is necessary should a medical emergency arise,
and I agree to pay for any necessary charges.
Checkout time is 11:00 am (except Sunday 1-5 pm). Pets may be picked up during normal business hours, but if not
picked up by checkout time, an additional day of boarding will be charged.
I understand that Coastal Animal Medical Center is not staffed 24 hours a day.
Receptionist:
I have read the boarding requirements and understand the hospital's policies.
Signature: