Boarding Requirements / Release Form | Family Pet Hospital

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All patients left in our care must have the following vaccinations current within the time period specified. Vaccinations are only valid if given in a veterinary facility. Dates of last vaccinations must be provided. If it is found that your animal is not current on vaccines, they will be given while your pet is here and the fee for those vaccinations will be applied to your boarding bill. Your animal must have had a negative fecal examination within the last 12 months.

CHECK YES IF DUE. CHECK NO IF PATIENT IS CURRENT.

DHLPP (1 year)

Yes
No

Bordetella (6 months)

Yes
No

Rabies (1 year)

Yes
No

Fecal Exam (1 year)

Yes
No

Heartworm Test 4DX

Yes
No

FVRCP (1 year)

Yes
No

Bordetella (1 year)

Yes
No

Rabies (1 year)

Yes
No

Fecal Exam (1 year)

Yes
No

Do your pet(s) need Heartworm &/or Flea/Tick Prevention refilled?*

Yes
No

Would you like your pet bathed?*

Yes
No

Are any medications necessary while boarding?*

Yes
No

If yes, what medications does your pet have?

I understand if I choose to pick up my pet(s) on Sunday at 5:00pm, I am still responsible for the boarding fee incurred for that night.

Special Instructions / Feeding Instructions*

Best Contact Phone #*

Additonal Requirements:

1. All animals must be free of external and internal parasites (ex. ticks, fleas, worms etc.), or they will be treated at owner's expense.
2. has my permission to do whatever is necessary should an emergency or illness arise.
3. If a tranquilizer is necessary for treatment or handling, has my permission to administer such medication.

I have read the boarding requirements and understand the hospital's policies.

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Boarding Requirements and Release Form

Client Info

Patient Info

Medical History

Additonal Requirements:

OTHER FORMS: