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3412 Maplewood Drive, Sulphur, LA 70663
Call Today: 337-625-2575
Email Us: info@maplewoodanimalhospitalsulphur.com
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Boarding Form
Thank you for choosing our Boarding Facilities!
Our facilities will allow your pet to be as comfortable as possible while you are away. Please feel free to contact us for a tour of our facilities at any time. Please do not assume your boarding arrangements are confirmed until we have contacted you to confirm the requested dates.
IMPORTANT: Boarding dates and arrangements are not confirmed until you have received notification. A staff member will contact you by phone or email.
Client's Name
*
First
Last
Pet Name
*
Breed
*
Sex
*
Age
*
Color
*
Phone Number
*
Drop off Date
*
Date Format: MM slash DD slash YYYY
Pick-up Date
*
Date Format: MM slash DD slash YYYY
Preferred pick-up time (if before noon)
Emergency Contact
*
Emergency Contact Phone Number
*
Authorization for release of pet to a person other than owner
Name
First
Last
Phone
Feeding Instructions
Select one type of food:
*
Food provided by kennel
My own food (provided at drop off time)
Feed my pet:
*
1x per day in the morning
1x per day in the evening
2x per day
3x per day
Amount of food given:
*
Medication Administration
Is boarding pet on medication
*
Yes
No
If so, please list all medications including dosage and frequency:
*
Bathing
Would you like your dog(s) to have a bath at an additional charge?
*
Bath includes nail trim, anal glands, shampoo & cage dry.
Yes
No
Boarding Pet’s Personal belongings
While we do our best to return items left with your pet at the time of discharge, occasionally items can be misplaced. Therefore, we cannot accept responsibility for leashes, toys, blankets, etc. that may be lost while your pet is boarding. If you would still like to leave any personal belongings, please provide us with a list below.
Health or Behavioral Problems
Does your pet have any medical or behavioral problems we should be aware of?
*
Yes
No
Does your pet have a history of cage, food, or animal aggression?
*
Yes
No
If my pet becomes anxious while boarding, I give my permission for an anti-anxiety / calming medication to be administered.
*
Should your pet show signs of aggression to our staff, we reserve the right to remove the pet immediately by way of you, thus terminating any further boarding reservations.
I understand
Authorization for Vaccination
Proof of current vaccinations is required (Rabies, DHPP, Bordetella, Fecal, Heartworm test, FVRCP, and FELV) for all boarders. If vaccinations can not be confirmed by the time of check in, we will administer the needed vaccines at your expense.
Authorization for Treatment
In the event that your pet experiences a life-threatening problem during his/her stay with us, a veterinarian will examine your dog or cat and will make every attempt to contact you. Medical treatment will be provided at the discretion of the veterinarian on duty. All costs associated with any medical care given while boarding will be at the owner’s expense and due upon your pet’s release.
Consent
As the owner or authorized guardian of the above named pet, I give permission to the doctors at Maplewood Animal Hospital to treat, prescribe or otherwise care for him / her as deemed necessary.
Flea Free Environment
To maintain a “flea free” environment, your pet will be checked for fleas upon admission. If fleas are present your pet will be treated with flea medication at your expense.
Consent
I understand that boarding my pet(s) at any facility, including Maplewood Animal Hospital involves placing my pet in unfamiliar surroundings. As a result, he / she may show signs of excitement, stress, and / or aggression while around other animals. I agree to hold Maplewood Animal Hospital (and it’s owners and staff) harmless for conditions that often are unavoidable in boarding environments, including but not limited to, my pet’s weight loss or gain, strained vocals, diarrhea, chipped nails or teeth, illnesses that become aggravated due to stress, rough hair coat, upper respiratory cough, injury, escape or death.
Consent
*
I understand that the facility is unstaffed after closing and my pet will be left unattended during those times during their boarding stay.
The undersigned acknowledges contracting for the above services and understands that any/all costs incurred will be the responsibility of the pet owner, and he/she is responsible for all balances due.
Name
*
Today's Date
*
Date Format: MM slash DD slash YYYY
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Home
New Clients
About Us
Make an Appointment
Team
Services
Pet Health
Pet Health Library
How-To Videos
Pet Health Checker
News
Product Recalls
Pet Insurance Info
Pet Food Recalls
Contact
Forms
New Client Registration Form
Boarding Form
Surgical Consent Form
Drop Off Form
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