Medical Boarding Drop Off Form Medical Boarding Drop Off Form Medical Boarding Drop-off Form Name * Name First First Last Last Pet's Name * Date * Home Phone Cell Phone Your you like us to text you? * YesNo Email * Emergency Contact Person * Emergency Contact Phone * **Due to OSHA safety procedures, raw food is not allowed in hospital** Diet * Did you bring your own food? YesNo Special Feeding Instructions Medications Special Treatments Personal Items Items brought in with your pet (please check all that apply) Collar Leash Carrier Description of item(s) Date to go home * Who will pick-up? * Permission to treat in case of emergency (if unable to reach contact person)? * Yes No To ensure the safety of all animals in our care, please be aware that if your pet is not fully vaccinated and contracts an illness while staying with us, we cannot be held responsible for any resulting medical cost. * I understand I, the undersigned, have read and fully understand the above information and procedures. Signature * signature keyboard Clear Today's Date * Please remember that you are always welcome to call us for updates regarding your pet!!If fleas are present upon examination, we will apply a flea elimination product to your pet and the charge will be added to your invoice. Please understand that it is necessary to safeguard our hospital. Captcha Submit If you are human, leave this field blank.
