Boarding Check-in Agreement
407-657-7297
Weight________ Date___________
Pick Up Date____________ Time_____ (Owner to call if pick up date changes)
Any food allergies? _________________
Has Advantage or
Frontline been applied? When?__________
Emergency Contact#
__________________________
Special Instructions:
________________________________________________________________
________________________________________________________________
Own Food? Or Kennel Food? (Science Diet Sensitive Stomach)
Feeding Instructions: How much and how often?____________________
Medications? Yes or No?
If yes, have they been given today? ________ (give medication to
receptionist)
Reasonable care will be used against injury, escape, or death of this
pet(s). The clinic and staff will not be held responsible for problems that may
occur given that reasonable care and precautions are followed. I understand
that any problem that occurs with my pet(s) will be treated as deemed best by
the staff veterinarians and I assume full responsibility for the treatment
expense incurred.
____________________________
Owner or Responsible Party
________________________________________________________________________
Office Use:
Ears ( ) (
)
Eyes ( ) (
)
Nose ( ) (
)
Skin
( ) (
)
Fleas/Ticks Yes/No
Description of
Abnormalities_______________
________________________________________