Boarding Form

Client Details

Client Id

Client Name

First Last

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Emergency Contact Name

First Last

Phone

Patient Details

Patient Name*

Gender*

Neutered Male
Male
Spayed Female
Female

Species*

Dog
Cat

Breed*

Spitz Color*

Birthdate*

Weight*

Boarding Details

Arrival Date*

Departure Date*

Would you like to request any additional services?*

Bath
Nail Trim
Anal Gland Expression

Requested services are provided at an additional fee.

Instructions

Medicine*

Exercise*

Feeding*

Belongings*

Notes*

Instructions*

Authorization

As the owner or authorized guardian of this animal, I give permission to the hospital to receive, treat, prescribe or otherwise care for the animal above as deemed necessary during its boarding stay. I understand that I must furnish a phone number(s) to reach me in case of an emergency, or provide the name and phone number(s) of an alternate contact person who is able to authorize services if I cannot be reached. In the event of an emergency, I understand that SVH will attempt to contact me at the phone number(s) that I have provided. Should injury or circumstance warrant the need for emergency service, I authorize SVH to treat my pet if deemed necessary for its health and well-being, and I agree to pay any and all expenses that may be incurred. I understand that if my pet is on medication, I will be charged accordingly for administration. I understand that if I do not bring my pet's own medication(s), I will be charged accordingly for any hospital medication used for my pet's needs. No contact with SVH for more than 30 days is considered abandonment and forfeits all ownership rights of my pet to Sheffield Veterinary Hospital.

I understand that it is recommended that pets be housed separately. By checking this box authorize my pets being housed within the same kennel and assume the risks in doing so.*

I agree

Name of Pet Owner or Person Responsible*

First Last

Date*

Boarding Release Form

Client Details

Patient Details

Boarding Details

Instructions

Authorization