"*" indicates required fields Client InformationName First Last Date MM slash DD slash YYYY Pick Up Date MM slash DD slash YYYY Pet Information #1ListPet's NameBreedAgeColorSex Male Female Is animal altered? Yes No CANINE VACCINESDHPCORONABORDETELLAPARVORABIESFELINE VACCINESFVRCPFELVFIPRABIESListDEWORMINGFECAL TESTHEARTWORM TESTEXAMBRIEF EXAMMEDICATIONINSTRUCTIONS + NOTES:BOARDING RATEBOARDING RATE PER NIGHT+ BATH+ MED/WALK FEE= DAILY TOTALPet Information #2ListPet's NameBreedAgeColorSex Male Female Is animal altered? Yes No CANINE VACCINESDHPCORONABORDETELLAPARVORABIESFELINE VACCINESFVRCPFELVFIPRABIESListDEWORMINGFECAL TESTHEARTWORM TESTEXAMBRIEF EXAMMEDICATIONINSTRUCTIONS + NOTES:BOARDING RATEBOARDING RATE PER NIGHT+ BATH+ MED/WALK FEE= DAILY TOTALPet Information #3ListPet's NameBreedAgeColorSex Male Female Is animal altered? Yes No CANINE VACCINESDHPCORONABORDETELLAPARVORABIESFELINE VACCINESFVRCPFELVFIPRABIESListDEWORMINGFECAL TESTHEARTWORM TESTEXAMBRIEF EXAMMEDICATIONINSTRUCTIONS + NOTES:BOARDING RATEBOARDING RATE PER NIGHT+ BATH+ MED/WALK FEE= DAILY TOTALEL TORO PET BOARDING IS TO USE ALL REASONABLE PRECAUTIONS AGAINST INJURY, ESCAPE, OR ILLNESS OF MY PET, BUT WILL NOT BE HELD LIABLE OR RESPONSIBLE IN ANY MANNER WHATSOEVER, FOR ANY CIRCUMSTANCE, ON ACCOUNT OF THE CARE, TREATMENT OR SAFEKEEPING OF MY PET; IT IS THOROUGHLY UNDERSTOOD THAT I ASSUME ALL RISKS. IF TRANQUILIZERS ARE NECESSARY FOR TREATMENT OR HANDLING, I GIVE MY PERMISSION TO EL TORO ANIMAL HOSPITAL TO ADMINISTER SUCH MEDICATIONS. ALL PETS ENTERING THE BOARDING FACILITY MUST BE UP TO DATE ON ALL VACCINATIONS. PETS MUST HAVE PROOF OF A VET VISIT WITHIN A YEAR FOR ANY VACCINES ADMINISTERED. PETS MUST BE FREE OF INTERNAL PARASITES (worms, protozoa, etc) AND EXTERNAL PARASITES (mites, fleas, ticks etc). A YEARLY FECAL TEST AND DEWORMING MUST BE GIVEN WITHIN A YEAR. PROOF OF THE ABOVE LISTED SERVICES MUST BE PRESENTED OR PETS WILL BE TREATED UPON ENTRY AT THE OWNER’S EXPENSE. I UNDERSTAND THAT IF MY PET BOARDS FOR 5 NIGHTS OR MORE A PAID BATH AT MY EXPENSE SHALL BE GIVEN. I ALSO AUTHORIZE EL TORO ANIMAL HOSPITAL TO DO WHATEVER IS NECCESSARY SHOULD AN EMERGENCY SITUATION ARISE. InitialPLEASE READ CAREFULLY AND SIGN BOTTOM OF BOARDING FORM.PETS ARE RELEASED MONDAY – FRIDAY 2PM – 5:30PM SATURDAY 12PM – 1:30PM UNLESS OTHERWISE ARRANGED AT THE TIME OF DROP OFF. NOTIFICATION OF ANY CHANGES (PICK UP DATE OR TIME) IS REQUIRED 24 HOURS IN ADVANCE IN PERSON OR BY PHONE BEFORE YOUR PET IS TO BE PICKED UP. NO EXCEPTIONS!Pets will not be released to unauthorized people without owners written consent. No exceptions will be made!Home PhoneCell PhoneEmergency Authorized parties to pick up Add RemoveSignature* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY Please answer the following questions:Has your pet(s) had any previous medical problems? Yes No If yes, please explain Does your pet(s) have any existing medical problems? Yes No If yes, please explain Has your pet(s) been seen in the past 12 months by a veterinarian? Yes No If yes, please list veterinarian and hospital BELONGINGS INVENTORYPLEASE LIST ALL BELONGINGS BROUGHT INTO THE HOSPITAL WITH YOUR PET. ITEMIZED LIST OF BELONGINGS WITH DESCRIPTION (EX. FOOD, MEDICATION, TOYS, BLANKETS) Add RemoveMEDICATION:NAME OF MED(S)MG’S OR CC’SINSTRUCTIONSGIVE WITH FOODLAST TIME GIVEN PRIOR TO DROP OFF Add RemoveEL TORO ANIMAL HOSPITAL AND ITS STAFF ARE NOT RESPONSIBLE FOR LOST OR MISSING BELONGINGS. BY SIGNING BELOW YOU AGREE NOT TO HOLD EL TORO ANIMAL HOSPITAL OR ITS STAFF RESPONSIBLE FOR BELONGINGS LEFT HERE.Signature* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.
