Boarding Check-in Form





Your First Name:
Your Last Name:
Emergency Contact Number:
Email:
Your Pet’s Name:
Type of Pet:

 

Important please read medical illness policy:

One of the advantages of boarding your pet at Desert Dunes Animal Hospital is that veterinary attention is readily available should the need arise. If your pet becomes ill we will call the emergency number listed above regarding your pets symptoms, treatment options, and estimate of additional costs.

 I understand that if I cannot be reached, I am responsible for the fees of medical treatment.


Please initial one:

 If my pet should become ill and require medical or surgical treatment, I give permission for the staff at Desert Dunes Animal Hospital to use any means necessary to treat my pet even in the event I am unable to be reached

 If my pet requires medical or surgical treatment do not exceed $

 Please call before performing any medical surgical treatment.


Preexisting medical conditions:


List Medications and dosing instructions:

 If medications are necessary for treatment and Handling I give permission to the doctors and technicians at Desert Dunes Animal Hospital to administer medications.


Boarding Requirements:

All pets left for boarding must be current on ALL required vaccines:

CANINE: Rabies , DHPPC , and Bordetella (every 6 months)

FELINE: FELV FVRCP , and Rabies .

*It is in the best interest of your pet to get due vaccines done 24-48 hour s before boarding.
 

 DHPPC

 Bordetella

 Rabies K9

 FVRCP

 FVRCP/LEUK combo Booster

 Rabies Feline


Belongings:

 Our kennel will supply the necessary accommodations for your pet's comfortable stay. If you choose to bring in be longs wit h your pet, Desert Dunes will not be responsible for lost or damaged items during your pets stay.

Please list belongings


Destruction of bedding, toys

Some dogs are inclined to chew or ingest objects such as blankets or bedding. If your dog has these tendencies, please let us know. Do we have permission to provide bedding for your pet?  Yes No


Feeding instructions:

Are you providing food for your pet to eat while in boarding?  Yes No

If ‘No,’ there will be an extra charge of $5 per day.

Are you providing treats?  Yes No

If ‘Yes’ , how often should they be given?

If you have multiple pets boarding together, is it ok for them to eat together?

 Yes No

If you have multiple pets boarding can they sleep together ?

 Yes No


Additional Services:

Please check the additional services you would like performed:

 Bath

 Nail Trim

 Ear cleaning

Does your pet need an exam by a veterinarian?

 Yes No

If yes fill out the following:

Reason for visit:
List any other problems noted:
Preferred doctor:
Is your pet scheduled for a surgical procedure while boarding:  Yes No
If so, what procedure :

Release of Liability

 I understand the conditions for boarding my pet at Desert Dunes Animal Hospital. I acknowledge that no employees or Desert Dunes Animal Hospital are her e overnight. By signing this release and waiver I am agreeing to hold Desert Dunes Animal Hospital and its employees harmless from any and all claims, damages or injuries.

Failure to pick up: California Civil Code

1834.5. Abandoned animal; disposition ; notice notwithstanding an y other provision of law, whenever any animal is delivered to any veterinarian, dog kennel, cat kennel, pet-grooming parlor, animal hospital, or any other animal care facility pursuant to any written or oral agreement entered into after the effective date of this section, and the owner of such animal do es not pick up the animal within 14 calendar days after the day the animal was due to be picked up, the animal shall be deemed to be abandoned. The person into whose custody the animal was placed for care shall first try for a period of not less than 10 days to find a new owner for the animal, and, if unable to place the animal with a new owner, shall thereafter humanely destroy the animal so abandoned. If an animal so abandoned was left with a veterinarian or with a facility which has a veterinarian, and a new owner cannot be found pursuant to this section, such veterinarian shall humanely destroy the animal. There shall be a notice posted in a conspicuous place, or in conspicuous type, and a written receipt given, to warn each person depositing an animal at such animal care facilities of the provisions of this section.

 I have read and understand the above terms.

 I accept all financial responsibility for services rendered.

 

Check to confirm submission.

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