Noah's Ark Vet - Boarding form

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Owner’s Name
First Name
Last Name
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Phone Number
Email
Emergency Contact
Phone Number
Pet’s Name
Canine
Please Select
Canine
Feline
Select one
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Boarding Drop off/ Pick up Hours:
Monday: 7:30 a.m.-12:00 p.m. & 2:00 p.m.-5:30 p.m.
Tuesday-Friday: 7:30 a.m.-5:30 p.m.
Saturday: 7:30 a.m.-11:30 a.m.
**Sunday discharge is offered upon request between 9:00-9:30 a.m. and 4:30-5:00 p.m. Clients requesting to pick up on Sunday will be required to have a credit card on file to be charged on Saturday prior to discharge during business hours.**
**Animals will be admitted and discharged ONLY during specified hours**
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Duration of StayDay-In / Day-Out
Check In Day: MM/DD/YYYY
Check Out Day: MM/DD/YYYY
AM
Please Select
AM
PM
Pick-Up Time
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**As we want to assure that every pet goes home clean, we STRONGLY RECOMMEND all dogs be bathed prior to discharge.**
BATH (dogs only)
NO BATH
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Medical Concerns
Allergies
Please Select
Please Select
Vomiting
Coughing
Loss of appetite
Diarrhea
Sneezing
Lethargy
None
Has your pet exhibited the following symptoms in the past two weeks?
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What medication(s) is your pet on?
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Medication
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Dosing instructions
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Day and time last given
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Medication
Dosing instructions
Day and time last given
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Feeding Instructions
In-House Food
Please Select
In-House Food
Own Food
Brand
How Much
How Often
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Additional Feeding Instructions
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Canine Pamper Package (Please fill out Canine Pamper Form)
Yes
Please Select
Yes
No
If yes, on these days
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Feline Pamper Package (Please fill out Feline Pamper Form)
Yes
Please Select
Yes
No
If yes, on these days
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In the unlikely event your pet becomes ill or injured while boarding, I agree to have (please check one)
Noah’s Ark
My regular Veterinarian
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Please Provide Detail's
Dr.
Clinic
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It is the owner’s sole responsibility to inform their veterinarian of this agreement. Older pets and pets with health problems are placed under stress when boarded. This stress can cause latent physical conditions (such a kidney, heart, and liver disorders) to surface.
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Personal Items
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Additional InformationVeterinary care
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**We will take every effort to maintain the condition and cleanliness of a pet’s personal item(s). However, please understand that personal items such as bedding, toys, or dishes may become damaged or soiled during a pet’s stay, and we are not financially responsible for items. **

Parasite Prevention

Pets staying at our boarding facility must be on flea prevention. If fleas are found on your pet during his/her stay, your pet will be treated for fleas at the owner’s expense.

In order to prevent the spread of intestinal parasites, pets that are admitted for boarding must be up to date on an intestinal parasite test (stool sample). If your pet is overdue on his/her fecal check, we will collect a sample during their stay. Testing and treatment will be at the owner’s expense.
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Flea/Tick Prevention (Brand)
Date Given
Heartworm Prevention (Brand)
Date Given
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Vaccines

All pets being admitted for boarding must have proof of current vaccines. Dogs are required to be up to date on Rabies, DHPP, and Bordetella. Cats are required to be up to date on Rabies and FVRCP, current Leukemia vaccine or prior negative test. If your pet is not up to date on vaccines at time of boarding admittance, vaccines will be administered at the owner’s expense. If your pet is vaccinated at another veterinary hospital, proof must be provided prior to boarding drop off time. If vaccines cannot be verified at time of boarding admittance, we will vaccinate according to our guidelines and at the owner’s expense.

Payment in full is expected when pet is released. No pet can be released until payment is made. The undersigned has read and understands the above and as owner or agent for the owner agrees to the above and to be responsible for any expenses incurred while boarding.
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Owner’s Signature
Clear
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Date
Date
Year
Month
Day
Should be Empty:

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