& Print: Boarding Check In Form

advertisement
Antonio Animal Hospital
Boarding Pet Information
The doctors and staff at Antonio Animal Hospital would like to make your pets stay with us as
comfortable as possible. Please help us by providing the following information:
I am requesting ______________________ to board (please select kennel size below)
from (date):__________________________ until (date and approximate time):_________________
*All prices include 3 walks and exercise per day*
32 square foot run, $55.00 per night
Large kennel, $50.00 per night
Medium kennel, $45.00 per night
Small kennel, $40.00 per night (Dogs 10 pounds or under only) & Cat Kennel, $30.00 per night
To prevent the spread of infectious diseases, boarding animals must be current on all vaccines. If
vaccines are due, they are required for boarding. To prevent the spread of infectious
parasites/worms, we recommend all boarded animals to be checked for internal parasites. (At a fee
of $55) Our records indicate that your pet’s vaccinations are due:
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
**Required vaccines for dogs are: DA2PP yearly, Bordetella every 6 months and Rabies every 3 years**
**Required vaccines for cats are: FVRCP yearly, FELV yearly and Rabies every 3 years**
Would you like us to give your pet a bath before you pick him/her up? The price for a bath would
be: _____________________
Yes
No
Would you like for us to do a bath special? The bath special includes a nail trim, routine ear cleaning
and anal gland expression. The additional charge is $25.
Yes
No
Please provide us with contact numbers to reach you while you are away:
__________________________________________________________________________________
__________________________________________________________________________________
In the event of an emergency and we are unable to reach you, please give us the name and phone
number for someone authorized to make decisions on your pet’s behalf in your absence:
__________________________________________________________________________________
Feeding Instructions:
Please feed the hospital brand food provided.
I have brought my own pet’s food. Brand: _________________________________
Feeding instructions: __________________________________________________________
Please list any belongings you are leaving here with your pet (toys, blankets, etc):
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
If you are leaving any medication with your pet, please list the medication and dosage here:
__________________________________________________________________________________
__________________________________________________________________________________
When did you last give your pet this medication? _________________________________________
I authorize Antonio Animal Hospital to care for my pet(s) while I am away. In the event of a medical
emergency, I authorize Antonio Animal Hospital to provide any necessary emergency medical
treatment to save the life of my pet and agree to pay all charges incurred. I have requested that my
pet(s) be taken for outdoor walks during his/her stay at Antonio Animal Hospital. I am aware that
my dog will be walked with a slip-lead leash and every reasonable care will be taken to protect my
pet. However, in the event my pet should get loose or hurt while on a walk, I release Antonio Animal
Hospital from all liability. Veterinary services during night time hours, some daytime hours, and/or
weekends, is provided at the discretion of the veterinarian in charge. Continuous presence of
personnel may not be provided during these hours. I understand that according to the Abandonment
Law of California, if any animal is NOT picked up within fourteen (14) days AFTER pick up date
noted, the animal is considered abandoned. I also understand and agree that in the event of default,
I am responsible to pay reasonable collection charges and/or attorney fees.
Owners Signature: __________________________________________________________________
Date: ________________________________________
Download