Scribd
Upload
47 views1 page

Pet Boarding Admissions Form

This document is a boarding admissions form for Lexington Veterinary Associates containing sections for client information, spouse information, pet information, emergency contact information, items being left with the pet, and the hospital's boarding policy. The final section is an authorization for the veterinary staff to provide necessary care for the pet(s) being boarded and an agreement to pay all fees when services are rendered.

Uploaded by

Michelle Renée Jenkins
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
47 views1 page

Pet Boarding Admissions Form

This document is a boarding admissions form for Lexington Veterinary Associates containing sections for client information, spouse information, pet information, emergency contact information, items being left with the pet, and the hospital's boarding policy. The final section is an authorization for the veterinary staff to provide necessary care for the pet(s) being boarded and an agreement to pay all fees when services are rendered.

Uploaded by

Michelle Renée Jenkins
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

BOARDING ADMISSIONS FORM

L E X I N G T O N V E T E R I N A RY A S S O C I A T E S
DENTON ANIMAL H O S P I TA L 175 Haywood Street Denton, NC 27239 336.859.2828
C L I E N T I N F O R M AT I O N

H I C K O RY T R E E H O S P I TA L 118 S Village Drive Winston-Salem, NC 27127 336.775.2303

JORDAN H O S P I TA L 300 Highway 64 E Lexington, NC 27292 336.249.3991

Name: Home Phone:


S P O U S E I N F O R M AT I O N

Work Phone:

Cell Phone:

Name: Home Phone:


P E T I N F O R M AT I O N

Work Phone:

Cell Phone:

Name: Name:

Breed: Breed:

Color: Color:

O T H E R E M E RG E N C Y C O N TAC T

Name: Home Phone: Work Phone: Cell Phone:

I T E M S L E F T A N D S P E C I A L I N S T RU C T I O N S

Please indicate if you are leaving: Food Descriptions and Special Instructions

Toys

Bedding

HOSPITAL BOARDING POLICY:


All pets must be clear of eas and parasites. Cats must be current on Distemper and Rabies vaccines. Dogs must be current on Distemper/Parvo, Bordatella, and Rabies vaccines.

AUTHORIZATION
I hereby authorize the veterinarian and staff to do whatever is necessary in case of illness or an emergency situation for the care of the above-described pet(s). If medications are necessary for treatment, I give my permission to administer such medications and I understand there is an additional charge for this service. I assume responsibility for all the charges incurred in the care of the animal. I also understand that ALL PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. Signature of client responsible for pet(s): __________________________________________ Date: __________________

www.lexingtonveterinaryassociates.com

You might also like