Boarding Pre Check-In Form Client Name*Pets Name*Check in notes:* Late Check Out? Grooming? Vet Appointment? (convenience care sheet completed)* Medications None*Medication NameDosage Food* Own Food Clinic FoodHow much/ How often*BelongingsCollar*Lead*Toys*Blanket*Bed*Are the required vaccines/tests current?* Yes NoDogs: 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 checkWhat flea prevention do you use?* Nexgard Simparica 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 NoIs your pet healthy today?* Yes NoDoes your pet have any of the following symptoms?* Coughing Sneezing Vomiting Diarrhea Changes in appetite or water consumption Seizures Red Skin Flaky Skin Dry Skin Scabs Ears: Red Ears: Discharge Ears: OdorOther - please list*Does your pet show cage aggression?* Yes NoDoes your pet have aggressive tendencies toward other dogs and/or people?* Yes NoIf yes, please explain*Has your pet bitten anyone?* Yes NoIf 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*Emergency Contact Name*Phone*MCAH*Authorized Pick up person*Phone*