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Letter to Editor 2
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Letter to Editor 1|
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| Boarding Check-In Form |
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| You can copy this form and fill it to save time when you bring your pet in. Central Animal Hospital BOARDING CHECK-IN SHEET CLIENT NAME______________________________________________________________________ PET NAME_________________________________________________________________________ BOARDING DATES FROM__________________________TO:_________________________ I hereby authorize and direct the Veterinarians and staff at Central Animal Hospital to board my pet during the above specified period. I have read Boarding at Central Animal Hospital and understand its contents. If my pet becomes ill or an emergency arises. I authorize Countryside Animal Clinic to perform diagnostics and treatments medically necessary to the health and well-being of my pet. I will be financially responsible for these services rendered. I understand my pet is required to be current on vaccinations and will be given a flea treatment to control external parasites. Please perform the procedures listed below. Charges will be in addition to those of boarding. My pet is on the following medications (INCLUDE heartworm preventative and flea treatments). Please include dosage schedule and date/time last administered. DRUG DOSAGE TIMES PER DAY LAST GIVEN MEDICATION BROUGHT Y/N _______________________________________________________________________________ Please be especially aware of these problems. _______________________________________________________________________________ My pet eats: Dry ___________________________Canned_______________________________ Feeding instructions: Amount:____________________________________________ Frequency:__________________________________________ Other:______________________________________________ *Unless pet’s regular food is provided, your pet will be fed the high quality prescription diet we provide. Items I am leaving with my pet ______________________________________________________________________________________________________________________________________________________________ In an emergency, please call: Name:_______________________________ Phone:____________________________________ Name:_______________________________ Phone:____________________________________ My pet will be picked up on __________________At approximately: am________ pm_________ By:_________________________ Family Member, Neighbor, Roommate, or Friend (circle one). Your pet will only be released to the person(s) specified above. __________________________________ _______________________________________ Signature of Owner or Responsible Agent Attendant’s Signature |
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