Owner Name:
Pet Name:
Boarding Dates:
TO
Pick Up Time:
check out time is 12:00pm, $25 daycare charge will be applied for late pick up. Fee is waived if you dog has Grooming/Bath appointment on check out day)
Bathing/Grooming for Boarding Pet (Charges depend upon size of pet. Includes nail trim and ear cleaning.)
(what day/time you want us to groom/bathe your dog)
Bath YESNO
Hair Cut YESNO
Emergency Contact:
Emergency Phone:
Boarding Pet’s Food Circle one
Food provided by Hotel ($5/meal) YESNO
My own food:
Is your dog allergic to any food
Feed my pet
Once a day AMPM
2 times a day
3 times a day
Amount of food given PER MEAL
Amount of food given PER DAY
Boarding Pet’s Medication：
Is boarding pet on medication? YESNO
Has he/she had all of today’s medication(s)? YESNO
Name of Medication:
Directions:
Boarding Pet’s Personal Belongings While we do our best to return items left with your pet at the time of (continued on back) discharge, occasionally items can be misplaced. Therefore, we cannot accept responsibility for leashes, toys, blankets, etc. that may be lost while your pet is boarding. If you would still like to leave any personal belongings, please provide us with a list below:
Health Questions Does your pet have any pre-existing medical problems we should be aware of?
Is there any other thing that we need to know about your pet that would help us? (Afraid of thunder storms, fractious, separation anxiety, etc.)
Has your pet been ill or showed any signs of illness in the past 2 to 4 weeks? If so, please explain.
Authorization for Release of Pet to a Person Other Than Owner If someone other than the owner is to pick up a pet from boarding, please let us know when that pet is brought in. We will not release an animal to someone other than the owner without prior authorization from the owner.
Person’s Name:
Phone Number:
Signature
Date:
Send
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