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Dog Boarding Form

Canine Boarding Admission Form

Please note this a request. A staff member will call to confirm your reservation.

Step 1 of 26

Personal Information

Name(Required)

First

Last

Email(Required)

Address(Required)

Street Address

City

State / Province / Region

ZIP / Postal Code

Contact Information

1st Phone Number

2nd Phone Number

Other Contact Forms

Pets Boarding(Required)

****CHECK IN****

We realize there’s no place like home, but we will try to make your pet’s stay with us as comfortable as possible. To help assure that every pet’s stay is pleasant and comfortable we do require that all pets staying with us are current on their immunizations and free of parasites.

VACCINATIONS: For the protection of all pets, any necessary vaccinations must be given if due, when your pet is admitted for boarding.

PARASITES: All pets must be free of internal parasites (worms) and external parasites (fleas and ticks), or they will be treated upon entry at the owner’s expense.

Date & Time of Arrival

Date

MM slash DD slash YYYY

Time

Hours

Minutes

AM/PM

Has your pet had any flea medications in the past 30 days?(Required)

Yes

If yes, what product was used and when it was administered?

REQUIRED PROCEDURES:
Rabies Vaccine (1 or 3 year)
DHPP Vaccine (1 or 3 year)
Bordetella Vaccine (w/in 6 months)
Fecal Floatation Test (w/in 6 months)

A wellness exam will be performed if the pet has not been seen by one of our veterinarians and needs an updated vaccination or if a vaccine is due and the pet has not been examined within the last (6) months.

OPTIONAL PROCEDURES:
Annual Lab Work/Heartworm Test (Recommend Heartworm screen every year)

ADDITIONAL PROCEDURES DUE OR SPECIAL INSTRUCTIONS

Boarding (Diet)

Does your pet have any food or medication allergies?(Required)

If yes, please specify

Did you bring your pet's food today?

Type of food

Eaten today?

Amount to feed

Additional feeding instructions

All pets not on a special diet will be fed Science Diet Adult Maintenance during their stay.

Medication

Is your pet currently on medication?

Meds Today?

Directions for Medicating

Medicating fees: once daily $6.50 per day, twice daily or more $8.50 per day.

Is your pet affected by Thunderstorms?

Does your pet require medication prior to storms?

Would you like your pet to have our “walk upgrade” while here?

(A walk upgrade is a 20 minute session outside for $9.00 per day)

Would you like your pet to have our “play upgrade” while here?

(A play upgrade is a 20 minute play session, fetch, toys, etc. outside for $11.50 per day)

PLEASE READ AND SIGN BELOW

Occasionally illness and emergencies do arise with boarding pets. For this reason we do require your permission to treat your animal should an illness or emergency occur. Minor concerns will be addressed at dismissal. If an emergency occurs we will make every effort to contact you.

Consent(Required)

I authorize Johnson County Animal Clinic to do whatever is necessary should require emergency treatment during his/her stay.

Signature(Required)

Date(Required)

MM slash DD slash YYYY

Contact Name(Required)

Contact Number(Required)

FACEBOOK: Can we post cute pics to our page?

I give Johnson County Animal Clinic LLC permission to use my pet’s picture during boarding or treatment for informational purposes on their website or facebook page. I understand Johnson County Animal Clinic LLC will protect my privacy and my pet’s privacy by not using names.(Required)

I do give permission

I do not give permission

****GOING HOME****

Pets will be discharged only during regular office hours.

Date & Time of dismissal(Required)

MM slash DD slash YYYY

Time

Hours

Minutes

AM/PM

26
Dogs boarded for 6 nights or more receive a complimentary bath the day of dismissal. Dogs boarded for less than 6 nights requiring a bath will be bathed at a discounted fee to be paid by the owner.

Bath on day of dismissal?(Required)

Nail Trim(Required)

Do you already have a boarding reservation scheduled with us?(Required)

Yes