Boarding Form Boarding Form Owner's Name * Owner's Name First First Last Last Email * Pet's Name * Date * Primary Phone * Alt Phone * Emergency Contact * Telephone * Boarding Start Date Boarding End Date We require that your pet(s) be current on vaccinations and general parasite screening as defined below. If your pet(s) received services elsewhere, you must show proof of current vaccinations and screening. If any vaccinations are due or past due, your pet(s) must be vaccinated prior to boarding, at an additional cost. Required Vaccinations & Screening Due Dates Rabies Vaccine Distemper Combo Vaccine (DHPP / FVRCP) Leptospirosis Vaccine (dogs only) Bordetella (dogs only) Heartworm Test (dogs only) Fecal (negative/NOS result) Diets We feed a bland diet at no charge. If your pet(s) is on a special diet, or you prefer it/they be fed its/their own food from home, you must provide the food. We ask that you the special diets be premeasured in a resealable bag or airtight container. This way, your pet(s) will receive the exact amount of food it/they receives at home, and it will stay fresh. I have brought my pet's diet today Treats: We offer your pet(s) treats daily; premium and seasonal treats are available for an additional charge. Rawhide, pig ears, hooves, etc., are not accepted for use in our facility. If your pet(s) is on a restricted diet, please make note of it here: Medication We can administer your pet’s medications during its/their stay. Medications must be in original packaging with pet’s name, medication name, type, and dosage instructions. Pills and Ointments $3.00 per dose, per pet. Injections $8.00 per injection fee, per pet. We will refill any prescriptions necessary at an additional cost. My pet's medication Personal Items Buffalo Grove Animal Hospital is not responsible for the loss of any personal item, any damage caused to a personal item, or any harm caused to the pet(s) by its own personal items. Each personal item must be clearly marked with a permanent, nontoxic marker. Each personal item must show the pet’s first and/or last name. Toys: Appropriate toys include those that are inedible and indestructible. Bedding: Bedding is provided for your pet to rest comfortably; personal bedding is discouraged for numerous health concerns. List Personal Items If you are human, leave this field blank. Next
