SRPH Boarding ContractOwners: _____________________________________________________
Contact number(s): ____________________________________
Pets Name: ________________________________________ Checking In: ___________________Checking Out: ___________________
Afternoon pick up:Y __N____ After hours pick up Day: ________________________ Time: 9am____6pm____
Current vaccines (you must provide proof of current vaccinations) yes____no____ verified by:______________________________
Services requested/required while here boarding:
Please note: There will be additional charges for medications given/medical treatments if done while here.
DHPP____ RV1yr____3yr____ Bordetella____ FVRCP____ FelV____ Heartworm test____ Proheart____
Any additional requests:_____________________________________________________________________________________________
Grooming____ Cut:________________________________________________________________Bath/Brush____ Owners initials:_____
Feed Instructions Owners: _______ Facilities: _______ Quantity: ____________________________ Frequency: ____________________
Treat Instructions Owners: _______ Quantity: __________ Frequency: _______________________________________________________
You MUST select either Y=yes or N=no for each of the following:
Is now or ever has been Aggressive or Possessive with any of the following:
People:Y___N___ Toys:Y___N___ Food:Y___N___ Animals:Y___N___ Ever Bitten Anyone:Y ___ N___ If yes to any, then please explain: __________________________________________________________________________________________________________
Is your pet afraid of noises:Y___N___ sensitive to touch:Y___N___ fearful of people/animals:Y___N___ If yes to any, then please explain:___________________________________________________________________________________________________________
Dogs: Climb 6’ fence;Y___N___ Dig under fence:Y___N___ Digs at doors:Y___N___
DID YOUR PET EAT THIS MORNING AND DID YOUR PET RECEIVE THEIR MORNING MEDICATIONS: yes _____no_____
your pet will be receiving medication while boarding all medication
must be labeled with written instructions attached to contract**
DOGS: Standard run__________ Deluxe run__________ with other family dog(s) Yes_____No_____
Playtime Allowed: With dogs from same household if kennels seperately: Yes_____ No_____
With dogs from other households allowed: Yes_____No_____
CATS: with other family cat(s) Yes_____No_____
Additional information/ medical/health concerns that we should know about, so our staff can provide the best possible care for your pet while it is at Sun Ranch Pet Hospital.__________________________________________________________________________________
The following days/times are not available for pick up or drop off:
New Year Eve evening, all day on New Years Day, 4th of July morning, all day on Thanksgiving Day, Christmas Eve evening or all day on Christmas Day.
Owner agrees that all information is accurate and true to the best of their knowledge. Owner agrees that they have read and fully understand and agree to the Terms of Agreement page and the Disclaimers and Additional Provisions pages and are entitled to copies of these upon request.
_______________________________________________ ____________________________________________ _____________________
Print Name Signature Date
ALL FEES DUE AT TIME OF SERVICES! Please circle your preferred method of payment.
CASH VISA MASTERCARD We Do Not accept Checks.