Client Name

First Last

Phone Number

Emergency Phone # (close relative/friend)

Pet’s Name:

Arrival Date

Departure Date

What heart worm preventative is your pet on?

Are any medicines necessary while boarding?

Yes

Give names of any medications and the dosage/times to be given:

NOTE: If your cat is on medications that were prescribed by another animal hospital, please provide copies of the related medical records.

Our medical staff will review the medications and the medical records. If your cat has not been examined by one of our veterinarians within the last 12 months, one of our veterinarians may need to examine your cat in order to ensure optimal care and safety during your cat's stay with us. If an examination is performed, normal fees would apply.

What food and how often will your pet be eating during their stay with us?

Does your pet have any food allergies or treat restrictions?

Yes

Please describe your pet's food restrictions:

Any coughing/sneezing/vomiting/diarrhea?

Are you leaving any property or belongings?

Would you like to receive text messages about your pet while you're away?

Yes

Cell phone #*

Are there any additional instructions or notes?

All pet resort guests must be current on required vaccinations and free of fleas and ticks, or they will be treated on admission at your expense. I authorize the above animal hospital to do whatever is necessary in case of illness or an emergency situation. I understand full payment by cash, check, credit card or care credit is due when my pet is released.

Resuscitate in case of emergency

Yes

I have read the boarding requirements and understand the hospital's policies.

Digital signature

Date

Boarding Release Form

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