Boarding Check-In Form

Client Name*

Pets Name*

Are the requirements listed below current?*

Yes
No

Dogs: Rabies vaccine, Distemper / Parvo vaccine, annual Bordatella vaccine, Canine Influenza vaccine, annual stool check, and annual Heartworm test

Cats: Rabies vaccine, FRCP vaccine, Leukemia vaccine or FELV test and annual stool check

What flea prevention do you use?*

Last given?*

Please note: Your pet will be checked for fleas upon arrival, if fleas are noted, your pet will be treated at your expense*

I give my permission for my pet to have peanut butter filled kongs and other “busy” toys provided by Paw Pur’s Place during their stay.

Yes
No

Is your pet healthy today?*

Yes
No

Does your pet have any of the following symptoms?

Other - please list

Do you wish for your pet to be seen by the Veterinarian while here?

(If yes, the Urgent Care sheet found on the website needs to be filled out by client)

Yes
No

Does your pet show cage aggression?

Yes
No

Does your pet have aggressive tendencies toward other dogs and/or people?

Yes
No

If yes, please explain

Has your pet bitten anyone?

Yes
No

If yes, please explain

Should injury or circumstance warrant the need for emergency service, I understand that the clinic will try to contact the necessary people before treatment, but will exercise the option to proceed if no one is available for approval.

Emergency Contact Name*

Phone #*

Regular Veterinarian Contact Info

Signature*

As the owner or authorized guardian of this animal, I give permission to MCAH to receive, treat, prescribe or otherwise care for the animal above as deemed necessary.

Enter the code below

Our Address

Hours

Like Us On Facebook