InstagramThis field is for validation purposes and should be left unchanged.Client Boarding Intake FormThis form is to be filled out once a year for every client using Preferred Veterinary Care's boarding facility. Please notify us if there are any health, medical, feeding, or medication changes with your pet in the meantime. For more than one pet, please fill out the "additional pet intake form" for each additional pet you will be bringing. Thank you! Visit Information: Boarding check-out is by 5:30 pm on weekdays. This provides our staff with enough time to clean and sanitize the kennel your pet was in, and wash and sanitize any bowls/blankets your pet may have used for the next pet coming in. We offer after hours pick up and drop off on Saturday and Sunday at 10 AM and 6 PM. We do not offer holiday pickup. Boarding check-in is anytime between 8 AM and 5:30 PM. Please let us know if you would like an after-hours pick-up or drop-off so that we can communicate that with our staff. Pets still in the facility after 5:30 PM on their pickup date will be considered staying another night, will be charged for an additional night, and ready for pick up the next day.Pricing Standard Boarding - $25 PER NIGHT PER DOG Multiple pet discount - 10% OFF BOARDING CHARGE Go home bath (canine) - $25 Go home nail trim - $12Reminders for boarding: 1. If your pet is taking any medications, please bring those with you in the original, clearly labeled containers. 2. If your pet has special dietary requirements, please bring enough food for the duration of their stay. We do provide in-house food, but strongly recommend bringing your pets food as a change in diet may cause GI upset. 3. We provide bedding and bowls, any items from home need to be clearly labeled. We strive to keep our hospital a safe place for all pets. We, therefore, require the following vaccines for all boarding animals: Dogs: Rabies, DAPP, and Bordetella. Cats: Rabies, FELV, and FVRCP.Name of PetBreedAgeThis agreement is made and entered into between Preferred Veterinary Care, hereinafter referred to as “PVC”, and the pet owner, hereinafter referred to as the “Owner”. Owner agrees that any belongings left with pet are left at will and PVC is not responsible for lost or damaged items.PREFERRED VETERINARY CARE DOES NOT PROVIDE 24 HOUR SUPERVISION If pet becomes injured or ill, or if the state of your pet’s health otherwise requires professional attention, PVC may treat the pet. A reasonable attempt will be made to contact you and your emergency contact before providing medical treatment. These treatments will be the responsibility of the owner. Owner represents to PVC that the pet has not been exposed to any contagious diseases within a 30-day period prior to check-in.I also understand that all canines must be current on their Rabies vaccine, annual Distemper Combination & annual Bordetella vaccinations, as well as free of internal and external parasites. If my pet is not current, or if parasites are found, he or she will be updated/treated by the veterinarian at PVC and owner will be responsible for any charges.If my pet should injure itself in an escape attempt, refuse food, soil itself, become ill, or die while at PVC, I will hold PVC and staff free of any responsibility and/or liability in the absence of negligence. I also understand that PVC reserves the right to separate or move my pet to another area of their facility, should they deem it necessary.In addition, I understand that daily boarding charges begin the date my pet is left with PVC. I agree to notify the hospital in advance if there is any changes in the date my pet is being picked up. In the event my pet is not picked up or paid for 7 days from the scheduled day of pick up, you may assume that the pet is abandoned. I authorize PVC to take any action it desires to place my pet. Abandonment will not release me of my obligation for the bill. No boarding pet will be released until all charges are paid in full. Medication information must be provided upon check-in.Interactive Playtime Permission: **Dogs Only** I hereby give Preferred Veterinary Care permission to allow my dog to interact with other boarding dogs when the kennel staff believes such interaction will be safe and beneficial for my pet's emotional and physical well-being. I will not hold Preferred Veterinary Care liable for any injury that may result from this interaction. There will be no extra charge added on to the daily boarding fee for this interaction. **IF YOUR PET IS NOT SPAYED OR NEUTERED THEY WILL NOT BE ALLOWED TO PARTICIPATE IN INTERACTIVE PLAYTIME WITH OTHER DOGS**Untitled Yes No Owner name First Last Owner signatureDate MM slash DD slash YYYY Client InformationName First Last PhoneEmail Address Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Emergency Contact/Second Owner: First Last PhoneAnyone else who may pick up your pet:Pet Information:/h3>NameBreedSexSpay/Neutered?WeightColorAgeName of clinic who last vaccinated your pet:PhoneFeeding Information:Brand of foodCups per mealMeals per dayDoes he/she eat immediately or graze throughout the day?Any Food Allergies?ReactionFood AggressionYesNoMedical Information: **This section is only required if your pet is a patient at another clinic.**Any medications your pet is on, dosage, frequency, and methods of administering(If not prescribed by our office):Any health issues?Has your pet been seen by his/her veterinarian in the past 6 months for anything beyond wellness visit and vaccines?Flea prevention, brand, and last dose givenBehavioral InformationYesNoDog friendly?YesNoBehavior/temperament issues?Does your pet try to escape from enclosed areas? If so, please detail:Any behaviors we should be aware of? Anxiety/fearful? Possessive/resource guard? Separation issues? Ect.If bringing multiple pets can they sleep together/ suite share?YesNoCan they eat together?YesNoCan they play together?YesNoAdditional Information:If your pet does not eat well may we add something to entice eating? (We usually add hill’s i/d canned food)YesNoMay we give anti-diarrheal medication if your dog has an upset stomach?YesNoMay we post pictures of your pet on social media?YesNoHas your pet ever bitten another person or animal?YesNoIs your pet people friendly?YesNoHas your pet ever climbed over/through a fence?YesNoAny other information you would like us to be aware about:Additional Pet(s) Information:NameBreedSexSpay/Neutered?WeightColorAgeName of clinic who last vaccinated your petPhoneFeeding InformationBrand of foodCups per mealMeals per dayDoes he/she eat immediately or graze throughout the day?Any Food Allergies?ReactionFood AggressionYesNoMedical Information **This section is only required if your pet is a patient at another clinic.**Any medications your pet is on, dosage, frequency, and methods of administering(If not prescribed by our office):Any health issues?Has your pet been seen by his/her veterinarian in the past 6 months for anything beyond wellness visit and vaccines?Flea prevention, brand, and last dose given:Behavioral Information:/Is your dog generally people friendly?YesNoDog friendly?YesNoBehavior/temperament issues?Does your pet try to escape from enclosed areas? If so, please detail:Any behaviors we should be aware of? Anxiety/fearful? Possessive/resource guard? Separation issues? Ect.If bringing multiple pets can they sleep together/ suite share?YesNoCan they eat together?YesNoCan they play together?YesNoAdditional Information:If your pet does not eat well may we add something to entice eating? We usually add hill’s i/d canned foodYesNoMay we give anti-diarrheal medication if your dog has an upset stomach?YesNoMay we post pictures of your pet on social media?YesNoHas your pet ever climbed over/through a fence?YesNoAny other information you would like us to be aware about