Boarding Check-In Form – Germantown Hills Animal Hospital

Owner's Name

First Last

Pet Name

Pet Description

Pet Name

Pet Description

Emergency Phone

Starting Date*

Must admit during business hours, Monday-Saturday.

Ending Date*

Pickup Time*

Morning
Afternoon

After hours must prepay

Pre-Boarding Checklist

Feeding Directions*

We feed Hills Science Diet Adult dry food, if you feed something different, please bring enough for your pet's stay.

Medication Directions*

Please list any medications your pet is currently on and directions for administering.

In Heat

If Yes, please call our office at 309-383-2356

Lameness

If yes, Examination Request?

Coughing

If yes, Examination Request?

Nails: Pedicure desired ($23.53)

Ears (waxy)

If yes, Examination Request?

Scooting

Anal Gland Expression desired ($34.65)?

Annual Intestinal Parasite Screening (Required) ($37.08)?*

Other Services Requested:

Flea Preventative (Required)*

Product Given

Date Last Given

Heartworm Preventative (Required)*

Product Given

Date Last Given

Heartworm Prevention Date Due

(Dogs Only) We require Bordetella Kennel Cough vaccine to prevent upper respiratory infections while boarding. Bacteria and viruses can be easily transmitted when dogs share the same air space. The vaccine is most effective when given 48-72 hours prior to exposure.

We do our best to keep your pet clean during his stay. However, if you would prefer a bath prior to discharge, we offer a $5.00 complementary discount for boarders. Please allow at least a 2:00pm check out for bathing.

Bath ($5.00 discount off reg. price)

Packages

We offer a Tender Loving Care (TLC) package for your playful pet in addition to the regular time spent in the exercise area. The TLC package includes 2 leash walkings per day.

TLC Package $28.84/night (one pet)
Basic Boarding $24.72/night (one pet)
TLC Package $42.23/night (2 pets)
Basic Boarding $35.02/night (2 pets)
Feline Basic $20.60/night
Townhouse(single) $25.75/night
Townhouse(mult) $33.99/night
Kitty Playtime $3.09/day

We require annual vaccinations to protect your pets from a combination of diseases. Our staff will notify you to discuss any vaccinations that are needed for their stay with us.

Consent

I understand the information provided on this form to be correct to the best of my knowledge. I grant Germantown Hills Animal Hospital employees and veterinarians to care for my pet in my absence. I understand that I am liable for all charges incurred for said care. I understand that all reasonable measures shall be taken to prevent loss, injury or illness and accept all risks there in during their visit.