Boarding Form OWNER CONTACT INFORMATIONName* First Last Phone*CHECK INDate Date Format: MM slash DD slash YYYY WeightPet's NameDogCatExoticWould you like to receive text updates while your pet is boarding?YesNoCell PhoneArrival Date Date Format: MM slash DD slash YYYY Pick-up Date Date Format: MM slash DD slash YYYY Pick-Up Time : HH MM AMPM EMERGENCY CONTACT INFORMATIONName First Last PhoneName First Last PhoneIs anyone other than you authorized to pick up this pet from boarding?YesNoName of Person Picking Up Pet First Last Cell Phone of Person Picking Up PetFEEDING INSTRUCTIONSAll boarding pets are fed Royal Canin Gastrointestinal LF Diet. We are happy to feed other diets at your request. We encourage you to bring your pet’s food during his stay with us. Please write your pet’s name and last name on any containers or bags you may be leaving with us.Normal diet foodAmount fed per feedingTimes of day fedLast time fedHave you brought food for your pet to eat while boarding?YesNoHave you brought treats for us to give your pet?YesNoHow often?OTHER SERVICESPlease check off any services you would like performed Bath (ear cleaning included) Medicated Bath No Bath Nail trim No trim Check nails Anal glandsOwner provided shampoo?YesNoOther services requestedMEDICATIONSType of heartworm and flea preventionDate of last prevention given Date Format: MM slash DD slash YYYY Please specify what medications your pet is on, the dosage/directions and when it was last given to themPERSONAL BELONGINGSWe provide every patient with comfy bedding. We strongly encourage you to leave personal bedding, clothing, towels or toys at home. We are concerned that your belongings will become lost or damaged. Please label any items that are being left with your name and your pet’s name. Any items that become soiled will be cleaned in house. We are not responsible for any lost or damaged items.Please provide a detailed list of any items being left with your petDoes your pet need to be examined by a veterinarian?YesNoReason for exam/visitDate of last vaccination Date Format: MM slash DD slash YYYY Name of clinic/hospitalCity and statePlease check that you have read and understand the following boarding guidelines:Should a pet become ill during their stay, we will make every reasonable effort to contact the owner and advice them of the situation. Until that time, LVH will be authorized to give necessary care or treatment for the pet at the owner’s expense.* I understand the above statmentAll pets must be free of internal and external parasites. Any pets found to have fleas, ticks, intestinal parasites or fungal infections will be treated immediately at the owner’s expense.* I understand the above statmentAll pets must be current on required vaccines. If pets are found to be overdue or if vaccines cannot be verified by phone or fax, they will be given upon admittance for boarding* I understand the above statmentBoarding pets can only be picked up from LVH during the following times: Monday through Friday, 7:30am-5:30pm, and Saturday, 8am-2pm* I understand the above statmentBoarding pets must be picked up prior to 2:00 pm, otherwise, they will be charged for that day of boarding.* I understand the above statmentI give permission for Lakeview Veterinary Hospital to use photos of pets on a website or social media.* I give permission I do not give permissionSignatureDate Date Format: MM slash DD slash YYYY