Name *

First

Last

Email *

Phone *

Check-In Date *

Date

Time

Check-Out Date *

Date

Time

Pet's Name *

Bath? *

Yes
No

Medication? *

Yes
No

There wil be an extra charge of $5.00 / day per pet for the administration of medication. If on medication please bring with your pet in it’s original bottle with label.

Add another pet? *

Yes
No

Pet's Name (#2)

Bath?

Yes
No

Medication?

Yes
No

There wil be an extra charge of $2.50 / day per pet for the administration of medication.

Add another pet?

Yes
No

Pet's Name (#3)

Bath?

Yes
No

Medication?

Yes
No

There wil be an extra charge of $2.50 / day per pet for the administration of medication.

Add another pet?

Yes
No

Pet's Name (#4)

Bath?

Yes
No

Medication?

Yes
No

There wil be an extra charge of $2.50 / day per pet for the administration of medication.

Emergency Contact *

First

Last

Emergency Contact Phone *

List Pet's belongings (carriers, toys, leashes, etc.) *

Special Instructions: (Include detailed medication directions and anything you wish the doctor to check)

FOR YOUR PET'S HEALTH

OUR VACCINATION POLICY: To insure protection of all pets under our care, we must have proof of current vaccinations of the following:

Dogs:
DA2PP (parvo combo)
Bordatella (Kennel Cough)
Rabies
Canine Influenza

Cats:
CVR-C (distemper)
Rabies

If proof of vaccination by a licensed veterinarian is not provided, I give permission to Magic Valley Veterinary Hospital to update my pets) vaccinations in accordance with the above policy. *

Yes
No

MEDICAL ILLNESS POLICY: One of the advantages of boarding your pets at a veterinary hospital is that veterinary attention is readily available should the need arise. If one of your pets becomes ill, we will call the emergency numbers listed above regarding your pet's symptoms, treatment options, and estimate of additional costs. If no one can be reached, however, please indicate your wishes below should your pet require treatment to relieve immediate discomfort or to resolve an important medical condition:

CHECK ONE: *

Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached. This includes only non-elective treatments and any necessary diagnostics.
I authorize up to a certain dollar amount that I will specify.
Do not administer any medical treatment until specific authorization is given.

I authorize up to: *

$100
$250
Other

If Other $

In medical care for my pet until someone can be reached.

I fully intend to pick up my pet on or around the above date specified. If circumstances change, I will notify the Magic Valley Veterinary Hospital of a new pickup date. No contact from me within 7 days of the scheduled pickup date will constitute abandonment of my pet. *

I have read and I understand.

Owner or agent for pet(S) *

Clear Signature

Date *

Boarding Form

FOR YOUR PET'S HEALTH

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