Owner Name

First

Last

Pet Name

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Date Of Admission

Expected Discharge Date

Discharge Time

Contact Name

Email

Phone Number

All dogs must be current on DA2P, Rabies and Bordetella (Canine Influenza is strongly recommended) unless there is a justified medical condition that prohibits vaccination AND it has been documented by a veterinarian; no exceptions. Proof of vaccine status is due upon drop off.

I have read and agree to the terms listed above

All cats must be current on core vaccinations (FVRCP and Rabies) unless there is a justified medical condition that prohibits vaccination and it has been documented by a veterinarian.

I have read and agree to the terms listed above

A negative fecal in the past 12 months must be recorded (proof due on drop-off). If overdue or if parasites are found on the pet during the stay, they will be treated as Dr. Norris determines, and the cost of the treatments will be included in the total bill.

I have read and agree to the terms listed above

All animals must be up-to-date on flea prevention.

I have read and agree to the terms listed above

If the pet is to be picked up by someone other than the owner, arrangements must be made with the hospital in advance. Please list the full name of agents other than yourself that are authorized to pick up your pet from the hospital or make decisions regarding the care and well-being of your pet while in our care:

I have read and agree to the terms listed above

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Agent Name

Phone Number

Please ensure that your designated agent is aware that you have given us his/her name and is willing and able to make decisions regarding the care and well-being of your pet.

Due to the stress of boarding, some animals need medication to calm them. We try natural options first (CBD treats, Zylkene) but reserve the right to prescribe something stronger in the case of severe anxiety or aggression. Charges will be assessed as needed.

I have read and agree to the terms listed above

All pets not picked up within 7 days after the expected date of pickup, without new provisions being made, will be considered abandoned and becomes the property of Good Friends Animal Hospital and will be handled according to our best judgment.

I have read and agree to the terms listed above

Please list all personal items left at the hospital with the pet. We assume no liability for lost or destroyed items during your stay.

Please list all medications including dosage and frequency:

Last dose administered:

Feeding Schedule

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Brand of food (dry)

Amount and frequency

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Brand of food (canned)

Amount and frequency

Treats

Please list any concerns to be addressed or services to be provided by the veterinarian during your pet’s stay. (Vaccinations, lab work, nail trim, anal glands, bath etc.)

Regarding a sanitary bath if boarder urinates/defecates on itself:

We do our best to keep your pet clean. Sometimes, an animal gets dirty while boarding. Should that happen, my wishes are as follows:

My pet can be bathed as needed before pick-up, should they need it. A fee of $17.50 will be assessed.
Do not bathe my pet, even if staff deems it appropriate.

Regarding the treatment of my pet during their stay:

If my pet becomes ill during their stay, I wish for the doctor to do the following (initial option):

Treat my pet as needed. I understand the doctor will attempt to call me as soon as any problem is found, but I authorize immediate treatment and/or stabilization as needed. Any additional verbal authorizations will be confirmed by two staff members.
Do not treat my animal until you have made contact with me. All verbal authorizations will be confirmed by two staff members.

I am providing written authorization up to $

The undersigned hereby warrants that they are the owner or authorized agent for the pet listed in this record and does consent and authorize Good Friends Animal Hospital to care for and treat said pet according to the above directives. I understand that every reasonable effort will be made to contact me as soon as possible if an emergency or unanticipated situation arises with my pet.

Signature

Clear Signature

Date

Call Us

Email Us

Location

Boarding Admission Form