Memorial Road Pet Hospital

Boarding Information

 

Check In Date:_________ Pick Up Date:__________

 

Owners Name: ___________________________________________________

 

Pet’s name(s): ____________________________________________________

 

What’s the best number for us to contact you at for this stay? ______________________

 

Feeding Instructions:

We provide Science Diet Maintenance/Puppy for all pets at no additional charge. If your pet is on a special diet please list along with feeding instructions.

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

 

Medications:

Is your pet on any medications? If yes please list all medications, quantity, and dosage. Please make sure all medications are in original prescription vial with Rx label. There is and additional fee of $3.90 - $7.80 per day for administering medications.

 

Pet:                  Medication:                Administration Instructions:

 

_______________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

 

_______________________________________________________________________

(If more room is needed please continue on back of form.)

Baths:

Would you like your pet(s) to have a bath before they go home? Baths are given the day of departure. If you are picking up on Saturday morning, the bath will be given Friday. There is an extra charge for baths and application of flea and tick preventatives. Please circle:

 

Bath:  Yes    No                      Apply Frontline                      Apply Advantage

 

Belongings:

Please list any belongings (leash, collar, treats, toys etc.) you will be leaving with your pet. Please mark their belongings with their name in magic marker. Due to the volume of belongings we handle we can not be responsible for any belongings left behind.

_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

Have a safe and happy trip!