Boarding Form

Please note that this is NOT a scheduling form. Please call the hospital to schedule boarding and confirm dates BEFORE filling this form out. This form alone does not guarantee a spot for your pet.

Client’s Name:*
First Last
Client #
Today’s Date:*
MM slash DD slash YYYY
Pets Name*
Animal
Age*
Sex*
Breed*
Boarding Dates:*

From - To
Pick-up Time*

AM/PM
Dr. Al’s Pup Pops - dog ice cream (additional fees apply):*
- Yes
- No
If yes, how many?*
Neighborhood Walk ~15 minutes (additional fees apply):*
- Yes
- No
If yes, how many?*
**If boarding multiple pets, would you like them housed together?*
- Yes
- No
Please list any belongings being left with pet:
**Please note that TAH can not be held responsible for any damage to personal items left with your pet**
Please list any medications your pet will need administered while boarding here at TAH. Please note there is an additional fee for medication administration per day.
Medication Amount/Frequency Last Given at
Will we feed IN-HOUSE food or will you provide your OWN FOOD?
Amount to feed*
Frequency*
Any special instructions?
Please list any allergies and/ or behavioral issues
In case of emergency, call
Name
First Last
Phone Number
Please list any representatives authorized to have contact with your pet during their stay:
Name Relation

Medication	Amount/Frequency	Last Given at

Name	Relation

In case of emergency, call