Owner's Name
(Required)
First
Last
Phone
(Required)
Email
(Required)
Pet's Name
(Required)
Reason for Drop-Off
(Required)
Are there any other services you would like to add for your pet today (check all that apply)?
Annual health/wellness exam
Anal gland expression
Microchipping
Vaccines
Heartworm prevention
Deworming
Flea/tick prevention
Lab testing/bloodwork
Heartworm test
Nail trim
Ear cleaning
Other
If other, please specify
(Required)
Are there any allergies, behaviors, or vaccine reactions we should be made aware of?
(Required)
Yes
No
If yes, please explain
(Required)
How often do we need to walk your pet while he/she is day boarding with us?
(Required)
We do not typically feed pets while they are day boarding unless you provide your own food. Does your pet need to be fed during day boarding?
(Required)
Yes
No
If yes, what food and how much/often?
(Required)
Do we have your permission to give your pet a treat while staying with us?
(Required)
Yes
No
*We provide Milk Bone treats for dogs and Friskies crunchy treats for cats
Questions for the veterinarian
What time will you be picking up your pet today?
(Required)
Hours
:
Minutes
AM
PM
AM/PM
What is the best contact number where you can be reached today?
(Required)
By signing this form, I understand that Express Vets is not permitted to have overnight boarders. I must pick up my pet(s) before the clinic closes at 5:30pm (M-F). If I fail to pick up my pet(s) before the clinic closes, I understand Express Vets staff may make other arrangements for my pet(s), and I will be responsible for any fees or costs associated with regaining possession of my pet(s).
(Required)
I have read and understand
Signature
(Required)
Date
MM slash DD slash YYYY