Section One: Client and Patient Information

UVH UNLEASHED BOARDINGFORMMust fill out all 10 sectionsin completion.

SECTION ONE: CLIENT AND PATIENT INFORMATION

Client Name: ______Phone: ______Email: ______

Emergency Contact Name: ______Phone: ______

Patient Name: ______DOB: ______Species: ______

Breed: ______Sex: ______Color: ______

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SECTION TWO: ABOUT THE VISIT

Arrival Date: ______am or pm Departure Date: ______am or pm

Someone other than you allowed to pick up your pet(s), please name:______
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SECTION THREE: VACCINATIONS and UVHvets Exam/ServicesIf any pets are not current for any of these vaccinations or tests, they will be updated while boarding. Please see our list of requirements online.

(A) Would you like us to have a doctor look at while your pet is boarding? If so, please list reason(s).

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SECTION FOUR: PERSONAL BELONGINGSWe supply fresh bedding daily and make sure our visitors are comfortable.

(A) Please list and describe all items that you will be bringing for your pets stay. All items need to be permanently marked with pet’s name.
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SECTION FIVE: MEDICATIONSAll meds must be in original prescription vial/ container with label, we will not accept them in presorted planner boxes or in daily zip lock baggies.

(A) If you are bringing a diet/treats from home or if your pet is on a prescription diet, please indicate brand, and instructions on amount to feed or how to feed, ie prefers warm, hand feed, etc.

(B) Do you need any medications, preventions, or treatsrefilled while your pet is with us?

(C) Do preventions need to be given to your pet while they are boarding? If so what day?

(D) Did your pet get their meds the morning of dropping them off?

(E) Do they need meds the night they are dropped off?

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SECTION SIX: FEEDINGAll pets are fed a gastrointestinal diet.

(A) If you are supplying their food, please label and leave instructions on what it is, how much, and how often.

(B) Has your pet been fed today?

(C) We feed twice a day, please make notes if your pet needs a different regimen.

(D) If boarding more than one pet from a household together:Do your pets need to be fed in separate areas? ______YES ______NO ______N/A

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SECTION SEVEN: BATHING or GROOMINGCanine visitors received a complimentary bath after three nights.

(A) Do you want your pet to have a bath the day they are going home? ______YES ______NO

(B) Do you want your pet to see our professional groomer during their stay? ______YES ______NO

Please meet with our groomer to speak with her about your wishes.

Please check any bathing grooming services you would like for us to perform while your pet is with us, pricing at check in or online.

Standard Bath (complimentary after 3 nights) - day they go home

Deluxe Bath -day they go home

Anal gland expression

Pedicure

Nail Grind/Dremel

Ear cleaning

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SECTION EIGHT: A LA CARTE We want to make your pets stay awesome, please see our list of special ways we can meet your pets needs and let us know if you would like additional Unleashed services.

Please check any of the additional fun we can have with your pet: if you want it more than once, let us know in the last section.

Peanut Butter Kong

Cat Kong

Chicken and Rice topping (1/4 cup)

Pumpkin Dessert topping

Belly Rub 5min

Belly Rub 10min

One on One Brush time 10min

Story Time 10min

One on One Fetch 10min

Cat Laser Play 10min

Cat Feather Play 10min

Advanced Training 15min – tell us what you want to work on (sit, stay, etc)

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LASTLY: Thank you for choose UVH Unleashed.Anything else you want us to know about your pets upcoming stay?

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University Veterinary Hospital

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