Boarding Admission Form

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Please list all animals being presented today for boarding:

Does your pet(s) have any problems or medications that we should be aware of?

We require all of our borders to be current on vaccinations. If your pet is not current on any of the vaccinations listed below, the vaccinations will be administered and cost added to your bill.

Dogs: Rabies, DHLP-PV-CV, and Bordetella

Cats: Rabies, Felv/fvrcp

ALL ANIMALS INFESTED IN FLEAS WILL BE GIVEN A CAPSTAR

Date you will be picking your pet(s) up

YYYY

Are there any additional procedures you wish to have done for your pet(s) while they stay with us?

Please list all Emergency contacts and phone numbers

I authorize the Claxton Veterinary Clinic to perform any procedures necessary to save the life of my pet(s) should any unforeseen circumstance arise. I understand that every effort to contact me will be made, but that such procedure may have to be performed before I am notified. I give full consent for such procedures. I also understand that I am responsible for the cost of any such life saving procedures. I release the Claxton Veterinary Clinic and any of its Veterinarians from liability resulting from any emergency procedures deemed necessary to try to save the life of my pet.

Digital Signature

Today's Date

YYYY

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