"*" indicates required fields

Client's Name*
Emergency Contact*
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Medical Concerns

Is your pet scheduled for any procedures while boarding?
Have you noticed any problems with your pet that we need to be aware of?
Do you authorize a doctor to evaluate?
Any known allergies?
Flea/Tick Prevention:
Heartworm Prevention:

Behavioral Concerns

Have you noticed any aggression/anxiety towards:
Select all that apply
Is your pet housebroken?
If boarding more than one dog/cat, are they housed togther?
Are they fed together?
Do authorize medical treatment if a problem is noticed while your pet is boarding with us?
*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?
*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?
Please list ALL medications
Drug Name
Dosage
Last dose given
 
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Did you bring your pet's food?
If your pet should run out of your food, can we feed our clinic food or is your pet on a prescription diet?
Please list ALL items you are leaving with your pet
*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?
*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:
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