Client Information

Phone

Emergency Contact Name

Emergency Contact Number

Patient Information

Patient

Reservation Date

Departure Time

For 1-ON-1 TIME: How often?*

For DAYCARE: How many days?*

BOARDING ACCOMMODATIONS

All pets must be current on the following vaccines & treatments:

RABIES
DHLPP
BORDETELLA
HEARTWORM TEST
FECAL FLOTATION
HEARTWORM PREVENTION (VETERINARY QUALITY)
FLEA & TICK PREVENTION (VETERINARY QUALITY)

FEEDING INSTRUCTIONS

Amount

Frequency

The last time your pet was fed?

Special feeding instructions (if any)

ATTENTION

All medications must be brought in their original bottles, and a dispensing fee will be added to your invoice. Medications, including supplements, that come pre-packaged in food cannot be administered. Medication charges are billed per night and can have up to 2 medications on a single charge.

Medical care will be given to pets that require medical attention while boarding. We will contact you by your preferred method to discuss treatment. D.r Ledger will do basic treatment for the pet's welfare at the owner's expense until we are able to reach you. If you consent to whatever treatment is necessary prior to your pets) stay then we will proceed with that route.

If major medical needs arise all patients will be transported to Blue Pearl Veterinary Emergency and Critical Care Hospital for treatment at the owner's expense.

Please initial one of the following:

I agree to allow basic treatment for my pets) until I can be contacted

I agree to allow whatever treatment is necessary if I cannot be contacted

Signature*

Date*

Name

This field is for validation purposes and should be left unchanged.

Boarding Drop Off