Boarding Form

Thank you for choosing Live Oak Veterinary Hospital as your boarding facility. To ensure the safety of your pet as well as others staying at our facility we require that your pet be current on all vaccinations and free of all external parasites (fleas/ticks). If we do not provide medical care of your pet at our facility please bring proof of vaccines. If your pet has external parasites, by signing this form, you agree that we may treat your pet at your cost for such parasites so as to not contaminate our facility or other pets.

Owner’s Name: ______________________________

Emergency Contact & Phone Number:___________________________________

Pet’s Name: ____________________________

Species: __________________ Breed: __________________ Sex: ___________

Date of Check-in: ______________Expected Check-out Date: ___________

Feeding:

Own food? _______________

Amount to Feed: AM_________________

Amount to Feed: PM___________________

Special Instructions: __________________________________________________________________________________________

In the last few days has you pet been: Coughing Y / N Sneezing Y / N

Vomiting Y / N Diarrhea Y /N

Have there ever been any problems boarding? _____________________________________________

Please List Any Allergies Your Pet Has: ___________________________________________________________________________________

 Personal Items left with Us: (We strongly recommend you do not leave any items)

___________________________________________________________________________________

Date of last application of flea/tick preventative: _________________________________________

Is there a flea/tick product that you prefer be applied to your pet if needed______________________________

Are there any other services that you would like performed on your pet by a veterinarian or staff while your pet is staying here?

__________________________________________________________________________________________

Do we have permission to treat your pet if he/she becomes ill while boarding here? _______________________

Health Issues:

Please list any health issues: ____________________________________________________________

Please list all medications your pet is currently taking:

Medication	Amount	Once Daily?	Twice Daily?	Other
1
2
3
4

 

Please note that payment is due in full at the time your pet is released from our facility. If you have another party picking up your pet, please make payment arrangements for payment with the other party prior to dropping off for boarding.

Signature: _________________________________Date:___________________