Boarding – Canine Boarding – Canine Boarding your canine companion with us? Fill out this form to save time at check-in! Please note we may have additional forms for you to sign at check-in. Name* First Last Phone*Email* Boarding Date From* MM slash DD slash YYYY Boarding Date To* MM slash DD slash YYYY Pet's Name* Is your pet on any medications?*There is a $4 charge per day for medication administration. Yes No Please list your pet's medications, dosage, frequency given and when last given.*Would you like your pet to have a nail trim while they are here?*(complimentary for stays of 7 or more nights) Yes No Would you like your pet to have a bath while they are here?*(complimentary for stays of 7 or more nights) Yes No Does your pet have their own food?*We offer dry food to your pet at no charge. If your pet requires wet/canned food and does not have their own, there will be an additional charge for this accommodation. Yes No How many times per day is your pet fed?* How much is your pet fed at each feeding?* Has your pet been fed today?* Yes No When did your pet eat and how much?* Is your pet current on flea preventatives?* Yes No What flea preventative is your pet on?* What date was flea preventative given last?* MM slash DD slash YYYY Is there anything else we should know about your pet?* Hospital Policies Crossroads Animal Hospital is committed to the best care of your pets. For this reason, we have put these policies in place. All pets must be current on vaccines and have an exam and fecal within a year. Any pets that are not current will be vaccinated at owner’s expense. We provide dry food to pets (wet food can be provided at an extra charge), but will feed them their own food if you bring it from home. Due to the risk of choking and potential for lost items we do not accept blankets, leashes, collars, beds, bowls, toys, rawhides etc. We are not responsible for lost items. Crossroads also requires all pets that are boarding to be current on a Prescription Flea/Tick preventative. If the pet is not, one will be given to them while they are here. Pets are required to have this so that cross infestations of fleas will not occur. An additional half-day charge will be applied to your account if your check out time is past 2 p.m. We take every precaution to preserve the well-being of every pet in our care, but cannot be held responsible for self-inflicted injury, escape or death of pet. In Case of Emergency In the event of a life-threatening emergency, we reserve the right to treat your animal.Indicate amount approved to be charged should your pet needs medical services while boarding* CPR RELEASE By allowing the doctor(s) and staff at Crossroads Animal Hospital to perform CPR, there are additional charges for which the client will be responsible. CPR for the first 15 minutes averages $100. If an emergency arises please:* DO perform CPR and other life saving measures. DO NOT perform CPR and other life saving measures. By signing below, I accept the terms of this boarding agreement. Client Signature*Date* MM slash DD slash YYYY Emergency Contact Phone Number* In
