Date Arriving *

Date Leaving *

Owner's Name *

First

Last

Pet’s name *

Best phone number in case of emergency *

Email *

Please note there is more information to fill out on the back of this form. Thank you.

Pet’s Basic Information

1. Is your pet on any medications or supplementations? *

Yes
No

Please name all medications, amounts, and frequency *

2. Are you providing food for your pet? *

Yes
No

Amount (in cups) and frequency *

3. Does your pet have any health issues (heart disease, anxiety, etc.) *

Yes
No

Please list all diagnosed conditions *

4. Has your pet shown any of the following symptoms in the last 7 days? If, yes please circle which symptoms your pet has shown. *

Yes
No

Coughing, sneezing, nasal discharge, watery eyes, or diarrhea

Services

Would you like any of the following services performed while your pet is boarding?

If other, please specify. *

Would you like your pet bathed before going home? If you are picking up on the weekends, baths are not available. *

Yes
No

Boarding Agreement Statement

Should my pet become ill or injured while staying at Delta Animal Hospital, I wish: *

Any procedures deemed necessary by the doctors at Delta Animal Hospital be performed
Please call me BEFORE treating my pet at all

While your pet is boarding, if intestinal parasites are noted in stools or if ectoparasites like fleas and/or ticks are noted, your pet will receive a dewormer or flea and tick preventative at your cost. This is to ensure the health and well-being of all pets in the hospital. *

I agreeing to the above statement

your Should Would

Your pet is required to be up to date on all vaccines within 7 days of their boarding reservation/drop off. This is to ensure the safety of not only your pet’s health but all other pets and hospitalized patients in the hospital. If your pet has updated vaccine records at another clinic, you will be required to provide those records to us before your pet can be dropped off for boarding. There is no exception to this rule.

Please initial the following statements of understanding *

I understand the above statement and agree to provide records of my pet’s vaccinations if needed.
I understand that it is my responsibility to acquire the required vaccine records and have them ready to present at drop off for my pet’s boarding. This will not be left to DAH receptionists to call another clinic and ask for records to be sent.
I understand that if my pet is overdue for vaccinations and there are less than 7 days until their boarding reservation, my pet will not be allowed to board at Delta Animal Hospital.

We, at Delta Animal Hospital, promise to give your pet the best care possible. Your pet MUST BE current on ALL vaccinations to be boarded in the kennel. Any pets admitted to the kennel with external parasites (fleas, ticks, mites) will be treated at the owner’s expense. These protocols are in place for not only your pet’s safety but as well as all other pets being boarded.

Owner’s Signature *

Clear Signature

Date *

Boarding Form

Boarding Form

Pet’s Basic Information

Services

Boarding Agreement Statement

Have a question?

Contact Delta Animal Hospital

Have a question?

Address

Contact

Hours