Please complete this form with all your pet's care information for every boarding visit.
Client's Name
Pet's Name (s)
Please list all pet's that will be boarding together in the same kennel.
Boarding drop off times are 8:00 am to 4:00 pm Monday-Friday and 8:00 am to 10:00 am on Saturday. The office is not open on Sundays.
Drop Off
Pick up
Boarding pick up times are 8:30 am to 5:00 pm Monday-Friday and 8:30 am to 11:00 am on Saturday. The office is not open on Sundays.
Feeding
ie- kennel food, own food
What brand of food?
How Much
ie- 1/2 cup, 1 cup
How Often
ie- once a day, twice a day, free feed
Does your pet need feeding in the morning when you drop off?
Does your pet need feeding in the evening when you drop off?
Please bring medications in their ORIGINAL BOTTLES including the label with dosing instructions from your veterinarian.
Prescriptions
Name of Medication (s)
ie- 1/4 tablet, 1/2 tablet, 1 tablet
ie- once a day, twice a day
Does your pet need medicating in the morning when you drop off?
Does your pet need medicating in the evening when you drop off?
Special Medicating Instructions
We will happily provide food, toys, treats, bowls, and bedding for your pet, it is not necessary for you to bring these items.
We will do everything to protect your belongings. We are not responsible for damage or loss of items. Please list all items, in detail, left with your pet.
Services
Other Service
Please note if your pet has a medical condition, illness, or special need.
For the protection of all the pets and staff at Countryside Animal Clinic, each animal that boards will be given vaccinations if needed and regular fees will apply. Dogs must be up to date on Rabies, Distemper, and Influenza vaccines, and both the kennel cough vaccine and intranasal bordatella. Intestinal parasite testing is required every 6 months for all boarding dogs, and if test results are positive, your pet will be treated according to the recommendation of your pet’s veterinarian. Cats are required to have yearly Rabies, Distemper, and Leukemia vaccinations, and a Feline Leukemia and Aids test.*
I understand that boarding facilities provide service for many animals and can be a stressful environment for some pets. There is the potential risk of communal disease spread. Countryside takes every precaution to maintain a safe environment and implement protocols for the health of all boarding pets. Regular fees apply for all medication and medical care, including any emergency care, administered to your pet if it is in our professional medical opinion necessary for the proper care, comfort, and well being of your pet and a healthy environment for other pets including treatment of boarding related illnesses, emergency care, intestinal parasites, fleas/ticks, bathing services, complications from existing conditions, stress-induced problems, pain management, or maintaining quality of life.*
If there is any evidence of fleas or ticks found on your pet, a bath, flea pill, topical, or appropriate treatment recommended by your pet’s veterinarian will be given. Regular fees will apply.*
Complimentary baths are given to dogs after a minimum of 4 nights. Fees will apply for requested baths or if a bath is required for the health and comfort of your pet. Complimentary nail trims will not be performed on pets that are fractious or become a risk to their own health or others.*
I give Countryside Animal Clinic permission to take and use photographs of my pet for any lawful purpose including publishing in print and/or electronically. *
All services will be rendered at our normal fee and payment will be due in full at the time your pet is discharged from boarding. Please let us know if you have any questions or concerns about your pet. If you have read and agree to the policies of Countryside Animal Clinic, please sign below as owner or agent.
Signature
Emergency Contact Name
Emergency Contact Phone Number
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One fine body…