Boarding & Bathing Form

Today's Date:

Boarding Date

Boarding Location:

Check all that Apply:

Boarding / Bath / Grooming Exam Needs:

Fecal FVRCP Lyme K9 Rabies 4 Dexx FIV/FeLV Feline Rabies Galaxy Kennel Cough

Boarding Needs / Concerns

Medications:

Own Food / Toys / Blankets:

Dog / Food Aggressive:

Share Boarding

Grooming / Bath Needs

Own Shampoo Yes No

Allergies Yes No

If yes, please describe them:

Medicated Bath Yes No

Vaccines

Authorization for Alternate person for Pick-Up Yes No

Name:

Telephone:

Emergency Contact:

Telephone:

TO INSURE THE PROTECTION OF YOUR PET AND OF OTHER, WE PROOF THAT ALL VACCINATIONS ARE UP-TO-DO IF PROOF IS NOT PROVIDED AT TIME OF BOARDING, BATH, AND GROOMING, VACCINATIONS WILL BE DONE AT TIME OF BOARDING BY THIS HOSPITAL.

DOGS REQUIRE:

An up-to-do-date Distemper / Parvo Vaccine
Rabies Vaccine
Kennel Cough Vaccine
Negative Stool Sample / 4dexx.

CATS REQUIRE:

An up-to-do-date FVRCP Vaccine
Rabies Vaccine
Negative Stool Sample

One of the advantages of boarding, bathing, and grooming at a veterinary hospital is, if and energency arises, medical attention readily available. if your pet becomes ill, we will contact you and discuss treatment options and estimate of additional cost HOWEVER, if you cannot be reached, please indicate your wishes below.

Perform whatever services the doctor deems necessary until someone can be reached.

I authorize the following amount in medical care until someone can be reached:

Do not administer any medical treatment until specific authorization is given.

I have read and understand this agreement. I fully intend to pick up my pet on the above specified date, or I will notify the hospital as soon as possible if dates / plans change. WE ARE NOT OPEN FOR PICK UP ON SUNDAYS!!

A 75% DEPOSIT IS REQUIRED AT STAR OF STAY

Check all that Apply:

Shirley Veterinary Hospital

RESOURCES

WE OFFER

WE ACCEPT