Boarding Admission Form Download and Print Form Boarding Admission Form "*" indicates required fields Client Name:* First Last Phone Number:*Emergency Contact Name: First Last Emergency Contact Phone:Patient Name:*Species:*Weight:*Arrival Date:* MM slash DD slash YYYY Depart Date:* MM slash DD slash YYYY All pets must be free of external parasites (fleas, ticks, etc.) or will be treated at the owner’s expense. All pets must be current on the following vaccinations: Dogs: Rabies DA2PP Bordetella Leptospirosis Highly recommended: H3N8 H3N2 Cats: Rabies FVRCP FELV Is your pet is up to date on all boarding vaccination requirements?* Yes No Please check what your pet is due for:* Wellness Exam Leptospirosis FELV Rabies H3N8 Fecal DA2PP H3N2 HWO Bordetella FVRCP Other Is your pet currently on any medications?* Yes No MedicationHow OftenAdd More + Yes No MedicationHow OftenAdd More + Yes No MedicationHow OftenIf my pet becomes ill while boarding, please provide the following care:* All diagnostics and treatment to be performed at the doctor’s discretion Only supportive care to be administered until I or my emergency contact can be reached. Diet:* Hospital Food Own Food Amount:*Exercise:* Add Playtime Once a Day ($12.31 for 20 minutes) Add Playtime Twice a Day ($20) None Please list the dates of desired playtimes:Please note: we do not offer playtime on Saturday or SundayWould you like to have your pet groomed before they leave?* Yes No Please note: prices for these services are additional and not included in the price of boarding.Please select grooming service*Select a serviceBath and brushEssential trimFull haircutWhat would you like to have done during the groom?*TLC Services: Daily Teeth Brushing ($10) Daily text or email updates ($3.60) Daily Coat Brushing ($9.30) Belongings: Forest Crossing is not responsible for lost items or the exit condition of the item. Items belonging to pet:REQUIRED NOTICE: LACK OF OVERNIGHT STAFFING AT FOREST CROSSING ANIMAL HOSPITAL Forest Crossing Animal Hospital does not employ on-site personnel during the hours of 6:00pm-7:00am Monday through Friday and 1:00pm-7:00am Saturday through Monday. All animals boarded at the Facility will be left unattended during those times. OWNER CONSENT AND RELEASE FOR DOG OR CAT TO BE LEFT UNATTENDED DURING BOARDING* I, the undersigned client, hereby give my consent for my pet named above to be boarded at the Facility on the following dates. I understand and acknowledge that the Facility is unstaffed between the hours specified in the notice and that my pet will be left unattended during those times during their boarding stay. By signing this consent form, I agree to release the Facility, its owners, employees and agents from any and all liabilities, claims or expenses that arise from my pet’s boarding stay, including but not limited to injuries, illnesses or death. I have read and understood the statements outlined in the notice and in this consent form and release. I voluntarily consent to my pet staying at the Facility and acknowledge that I am solely responsible for any consequences that might arise during their stay.Signature*CAPTCHA Δ
