Chateau Animal Hospital
Boarding Check-In Sheet
Pet’s Name ________________________
Pick up Date: ____________________
__________________________________
Pick Up TIME: ____________________
Emergency Number (s):
1. ___________________________
2.____________________________
Did you bring own food? ⃝ Yes ⃝ no
Feeding instructions if own food:____________________________________________________
Brand name and/or kind of container brought:_________________________________________
Treats Brought (how many per day):__________________________________________________
Are there any medications to administer during your pet’s stay? (There is an additional charge for this)
If yes, please specify ______________________________________________________________
Please list/describe all belongings staying with your pet (including leash and collar): **CHATEAU ANIMAL
HOSPITAL IS NOT RESPONSIBLE FOR BELONGINGS LEFT IN THE CLINIC DURING YOUR STAY.**
We require that all pets be up to date on all vaccines, including influenza vaccine while boarding here. If your
pet gets vaccines elsewhere, please let the receptionist know so we can call and get vaccine history and update
our records.
Are there any treatments your pet will need while boarding with us?
⃝ I decline an exam at this time-Owner initials_______
⃝ Check-up/exam-list any concerns for the doctor to review___________________________________
⃝ Vaccines
List all services you wish to pamper your pet with during his/her stay, please choose at least one option:
⃝ Spa (bath, brush teeth, clean ears, trim nails, express anal glands, perfume spray)
⃝ Bath ( It is suggested that all boarders staying 3 or more days should be bathed)
⃝ Decline bath- Owner initials _________
⃝Nail Trim
⃝Groom-prior appointment required
Do you give Chateau Animal Hospital permission to allow your pet(s) to be off leash in our fenced playground?
Chateau Animal will do everything we can to assure the safety of your pet(s) but does not assume liability if
pet(s) try to jump the fence. This option may not be available for all pets.
Initial- YES_______ NO_______
Flea and Tick prevention is the responsibility of the client!
Would you like your pet treated with Frontline Tritak or Nexgard? Circle YES or NO
If your pet is in need of medical treatment, how should we contact you?
⃝ Emergency number___________________________________________________
⃝ Email______________________________________________________________
⃝ Proceed with treatment without contact-Owner Initials____________________________
Chateau Animal Hospital reserves the right to move any pet to a different area than previously arranged while
staying in the clinic for health and safety purposes.
OWNER/AGENT_____________________________________________ DATE________________