Alpharetta Animal Hospital-Pet Boarding Instructions & Consent Form

Pet Owner Information

Pet Owner's Name*

Pet Owner's Email*

Pet Owner's/Emergency Phone Number*

Pet Owner's Address*

Pet Information

Pet's Name*

Breed Type*

Color

Dog or Cat*

Instructions

Diet and Feeding instructions*

Medications

Medication Name

Description

Time

Dosage

Medication Name

Description

Time

Dosage

Medication Name

Description

Time

Dosage

Medication Name

Description

Time

Dosage

Would you like your pet to have a BATH before going home? Our bath includes a nail trim, ear cleaning and anal gland expression.*

YES

NO

NAIL TRIM ONLY

If more than one pet is boarding with us, will they be boarding together?*

YES

NO

Would you like your pet to have any bedding while here?*

YES

NO

Waiver & Consent

1- I confirm that I own the pet or I was given authority by the owner for taking ownership of the pet.
2- I confirm that my pet has updated vaccinations and if not, Alpharetta Animal Hospital will vaccinate for the required vaccines for boarding (Rabies, DHPP, Bordetella for canine and Rabies, FVRCP for feline).
3- I confirm that my pet is on monthly flea prevention or, if not, Alpharetta Animal Hospital can treat my pet(s) for fleas at owners expense.
4- If my pet needs medical attention, I authorize Alpharetta Animal Hospital to have it looked at by a veterinarian.
5- I confirmed that all information I entered in this form is true and accurate.

I agree to terms indicated above and will follow it.

Signature*

Date Signed