Boarding Admission Form

Client's Name:

Pet's Name:

Species:

Age:

Contact Name:

Contact Numbers:

Multiple pets boarding? --- Yes No If so, do you wish for them to board together? --- Yes No

I give my permission for my dog to be walked on a leash outside.

Has your pet recently been ill? --- Yes No If yes, please specify:

Medical Services

• Exams & Vaccines
• Dental Cleaning
• Senior Testing
• Surgery
• Microchipping
• Comprehensive Wellness Exam ($50)

Grooming Services

• Bath
• Nail Trim
• Anal Glands
• Clean Ears
• Groom
• Lucky Dog Upgrade ($15)

Does your pet need any medication? --- Yes No

If yes, what and how often?

Did you bring your pet's food? --- Yes No

If yes, what and how much should we feed?

Please list any belongings you brought for your pet:

Please list the name(s) of anyone else authorized to pick your pet up from boarding:

Date In:

Date Out:

Approximate Pick-up Time: --- Early A.M. Noon Late P.M.

• ALL ANIMALS MUST BE CURRENT ON ALL VACCINATIONS. Proof must be shown within one hour of check-in or they will be given at the owner’s expense.
• All animals must be free of internal and external parasites or they will be treated at the owner’s expense.
• If your pet should become ill during the stay and you or your emergency contact cannot be reached, we will treat, prescribe for, or operate upon the pet as necessary and adjust the bill accordingly.
• Pets are expected to be released on the date specified above (unless alternate arrangements have been made). If you do not contact us within seven (7) days, your pet will be considered abandoned and will be placed for adoption. It is understood that such action by the owners does not relieve them from paying all costs that have incurred.
• Boarding animals are fed twice daily and dogs are walked three times daily unless you specify otherwise.
• Sugar Creek Animal Hospital is not responsible for any damaged or misplaced items brought by the owner.

I have read the foregoing and agree.