Boarding Check-in Form - Riverstone Animal Hospital

Transcription

Boarding Check-in Form - Riverstone Animal Hospital
Boarding Check-in Form
Please be sure your reservation has been confirmed before filling out this form.
Has your reservation been confirmed with a Riverstone Animal Hospital employee?
Yes
No
If not, please wait for confirmation before completing this form.
Client Name
Last
First
Phone
Patient(s) Name
Please list all pets boarding for this reservation.
Boarding Arrival Date
Boarding Departure Date
For Sunday pick-ups only: By checking the box below, owner understands that pets may not be dropped off on a
Sunday, that Sunday pick up is between 5-6 PM, that pre-payment for boarding is required, and that owner WILL
still be charged for Sunday night.
Yes
Is Your Pet(s) Current on Vaccinations?
Yes
No
For Dogs: Your pet MUST be current on Rabies, Distemper-Parvo, and Kennel Cough vaccines in order to board.
For Cats: Your pet MUST be current on Rabies and Feline Distemper vaccines in order to board.
If vaccinations for your pet(s) were administered at another clinic, please list clinic name below
For your pet's safety, ALL guests must be current on vaccinations and we must have written confirmation from a
licensed veterinarian PRIOR to boarding. By checking the box below, owner consents that any guests without
proof of vaccination will be vaccinated at their owner's expense. All guests must also be free of external and
internal parasites or will be treated accordingly at their owner's expense.
Yes
Will you have multiple pets boarding?
Yes
No
For multiple pets: will your pets be boarding in the same enclosure?
Yes
No
For multiple pets: Do your pets need to be separated during meal times?
Yes
No
Check-out time is 2:00PM. By checking the box below, owner consents that an additional nightly charge will be
added if pet(s) is picked up after 2:00PM.
Yes
What time will the pet be picked up on the day of check out?
AM
:
HH
MM
If you do not know an exact time when you will pick up your pet, please indicate a time either before 2:00PM to avoid an additional nightly charge,
or a time after 2:00PM to indicate that an additional night will need to be added to your charges.
Will your pet(s) be receiving playtimes while boarding?
Yes
No
All pets receive 3 walks per day. Playtimes are an additional 15 minutes of one-on-one time with a kennel assistant, and cost $5 each. PLEASE
NOTE: During peak boarding times (holidays & summer), we may only allow one playtime dally per pet.
If your pet(s) will be receiving playtimes while boarding, select how often you'd like playtimes:
Once daily
Twice daily
Once every other day
Other
If receiving playtimes, would you like to receive a picture text message of your pet(s) at no additional charge?
Yes
No
Please Note: During peak boarding times (holidays & summer), it may not be possible for us to send a picture text, but we will do our best to send
one to you at some point during your pet's stay.
If receiving a picture text, what phone number would you like to have this sent to?
Will your pet(s) be getting a bath before going home?
Yes
No
Unsure
Please note: Any dog staying in a luxury run or suite for 3 or more nights will receive a complimentary bath (including nail trim, ear cleaning, and
anal gland expression). Any dog boarding in a basic area will be charged for a bath based on weight. Cat baths usually require previous approval as
sedation is usually needed, requiring additional time & charges.
Will your pet(s) need any medications while boarding?
Yes
No
If your pet(s) will need medications while boarding, please list the medication name(s) &dosing
For boarders with medications: Due to the need for medical supervision, owner understands that by checking box
below, an additional $5 nightly charge will be added to the invoice of any pets requiring such services. The
administration and overseeing of medications is performed by a technician.
Yes
What food will your pet(s) be eating while boarding?
House food
Owner-provided food
House food is Royal Canin Gastrointestinal Low-fat for dogs, and Royal Canin Young Adult for cats.
If providing your pet's food, what brand (if known)?
How much food would you like us to feed your pet(s)?
If you do not measure your pet's food, please indicate "free feed."
Would you like us to feed your pet once daily (AM or PM), or twice daily? Twice daily
If your pet is NOT eating, do you give consent for us to mix their food with a high-quality canned food?
Yes
No
Will You Bring Any Belongings for Your Pet(s)?
Yes
No
Please note: During holidays, all belongings MUST be labeled PRIOR to coming in for boarding. We cannot be responsible for personal items
brought by owners; if personal items are brought, we have the right to place the patient's name on the item.
If bringing belongings for your pet(s), please list them below:
Are there any special instructions or additional services that your pet(s) needs while boarding to make them more
comfortable?
Submit