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Pet Lodging Instructions
This form must be complete each lodging visit. (Your email is used for receipts and confirmation purposes only)
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Email
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Your email
Owner Information
Full Name
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Your answer
Address
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Your answer
Phone
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Your answer
Drop off date
MM
/
DD
/
YYYY
Date expected to pick up pet?
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MM
/
DD
/
YYYY
I am aware that an additional fee is added when dropping off or picking up is on days closed.(PLEASE NOTE: ANY DROP OFF ON DAYS WE ARE CLOSED MUST BE SCHEDULED AT 12 NOON OR 5 PM {EX: SAT-MON OR HOLIDAYS}) . This convenience does have a fee added to the day.
yes
No
12pm drop off
5 pm Drop off
12 pm pick up
5pm pickup
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Emergency Contact Name, Phone, and Address
*
Your answer
Lodging Instructions
Please make sure to clearly state which pet the information relates to.
Feeding Instructions - List pet name, amount, time, and type. For example: Dixie eats 1 cup in the morning of dry dog food with her name on it.
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Your answer
Allergies - List pet name and type of allergy.
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Your answer
Medication(s) Name, Pet Name(s), Amount of Dose, and Distribution Time - Include any special instruction on how to distribute the medication(s). For Example: Dixie gets three NuVet pills in the the morning to help with her arthritis.
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Your answer
Dislikes - For example: Dixie does not like her ears being touched.
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Your answer
Favorite toys or games - For Example: Dixie likes fetch and tug of war.
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Your answer
We give you permission for one or more of your pets to participate in a group play session. This is where no more than 3 pets play together (same or different households).
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Yes, I give consent for my pets to participate in a group play session with like species (dogs with other dogs & cats with other cats).
No, I do not give my consent.
If you would like one or more of your pets to participate in group play sessions, list the pet name & what type of play is okay. For Example: Dixie can play with dogs who are smaller than her and dogs who don't bark.
Your answer
Anything else we should know?
Your answer
Pet Medical Emergency Information
Emergency Veterinarian Name, Phone, & Address
*
Your answer
We give you permission to authorize emergency medical care for our pet(s) as deemed necessary by the above veterinarian, and we will be responsible for full payment of such care.
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Yes
Digital Signature - By typing full name below we agree to authorize emergency medical care as directed above
Your answer
Date of Digital Signature
MM
/
DD
/
YYYY
We give permission to use the credit card information for billing of our pets stay for deposit to be applied to final bill
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Yes
No, we will provide another form of payment at pick up
We want full grooming to take place during the stay. *NOTE: This is subject to availability and is not guaranteed.
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Yes
No
We want nail service ONLY provided
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Yes
No
I have read the above and indicated the authorized services. We understand we will be responsible for full payment of such work and agree by typing our full name in for a digital signature
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Your answer
Date of Digital Signature
MM
/
DD
/
YYYY
Send me a copy of my responses.
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