Boarding Form

Pet's Name*
Client's Name*
First Last
Phone Number*
Emergency Contact*
First Last
Emergency Phone Number*
Admission Date*
Date Format: MM slash DD slash YYYY
Discharge Date*
Date Format: MM slash DD slash YYYY
Medical Concerns
Have you noticed any problems with your pet that we need to be aware of?
- Yes
- No
If yes, please describe
How long has this been going on?
Do you authorize a doctor to evaluate?
- Yes
- No
Any known allergies?
- Yes
- No
If yes, please describe
Flea/Tick Prevention:
- Yes
- No
Brand / Last Given
Heartworm Prevention:
- Yes
- No
Brand / Last Given
Behavioral Concerns
Have you noticed any aggression/anxiety towards:
Select all that apply
- Women
- Men
- Strangers
- Other dogs
- Thunderstorms
- Food aggression
Is your pet housebroken?
- Yes
- No
If boarding more than one dog/cat, are they housed togther?
- Yes
- No
Are they fed together?
- Yes
- No
Do authorize medical treatment if a problem is noticed while your pet is boarding with us?
- Yes
- No
*If evidence of fleas or ticks is noticed, we will administer or apply flea/tick treatment during your pet’s stay*
Would you like us to contact you when problem is noticed?
- Yes
- No
*In the event of a serious medical condition, if we are unable to reach you, your pet will be treated at the Doctor's discretion until reached.*
Is your pet on any medications?
- Yes
- No
Please list ALL medications
Drug Name Dosage Last dose given

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What brand of food do you feed?
Wet/Dry/Both?
Did you bring your pet's food?
- Yes
- No
How many times a day do you feed your pet?
Amount?
Please list ALL items you are leaving with your pet
- Leash
- Collar
- Harness
List and describe any other items:
*i.e. If you are leaving a blanket/towel, please describe color; if you are leaving toys, please describe*
Does your dog eat or chew on his bedding at home?
- Yes
- No
*We reserve the right to withhold bedding and toys for your pet’s safety if we feel there’s any risk of a G.I. block from the items
If boarding for 7 days, or longer, we offer complimentary baths.
*Please note, it must be an afternoon pick-up to receive a complimentary bath*
Do you request a complimentary bath IF boarding 7 days or longer:
- Yes
- No
Please list any additional concerns/instructions we need to know to care for your pet:
Owner's Signature*
Date*
Date Format: MM slash DD slash YYYY
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Email
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Boarding Form

Medical Concerns

Behavioral Concerns

If boarding for 7 days, or longer, we offer complimentary baths.

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Drug Name	Dosage	Last dose given