Boarding Form Step 1 of 4 25% THIS IS NOT A RESERVATION! FILLING OUT THIS FORM DOES NOT ENSURE THAT WE HAVE SPACE FOR YOUR PET! PLEASE CALL THE OFFICE TO RESERVE A SPACE FOR YOUR PET TODAY.Client's Name* First Last Your Email* Pet's Name* Part 1 - FEEDING AND SERVICE NEEDSI Will Pick Up My Pet This Date and Time Date* Date Format: MM slash DD slash YYYY Time* : HH MM AM PM I Brought My Pet's Own Food*YesNoMy Pet Is On A Special Diet*YesNoPlease List Pet's Special DietMy Pet Eats (please check one)*A.M. OnlyP.M. OnlyA.M. and P.M.At WillMy Pet Eats (list amount)*My Pet's Next Feeding Is AtDate* Date Format: MM slash DD slash YYYY Time* : HH MM AM PM My Pet Needs A Bath, Brush Out And Nail Trim **If having a bath, pick up is after 4:30p and before 6:00p*YesNoMy Pet Needs A Nail Trim Only*YesNoMy Pet Needs His/Her Anal Grands Expressed*YesNoI Have Pre-Arranged Grooming With Susan*YesNoMy Pet Needs An Examination (Please specify)I Am Leaving The Following Items With My Pet (Press the + button to add multiple items). Although we try to make sure your pet goes home with what he/she came with, we are not responsible for lost items or items left here while boarding. Please See Specific Notes About My Pet Listed Below Part 2 - MEDICATIONSMy Pet Is On Medications*YesNoList Medication, Dosage, and Next Dosage Time (click the + button to add multiple medications) Part 3 - EMERGENCY INFORMATIONPlease Do Not Treat My Pet If He/She Becomes Ill Without Calling Me First*Yes, call me before treatingYes, please treat my pet prior to callingPlease Treat My Pet Up To This Dollar Amount If He/She Becomes Ill Before Calling Me*Two Emergency Numbers That I Can Be Contacted At AreEmergency Phone Number*Emergency Phone NumberI understand my pet will be treated for any internal/external parasites noticed while boarding. By checking this box, you accept these terms.* I accept these terms I Want My Pet To Have Play Time When Available ($7.00 per half hour)*YesNoEnter Number Of 30 Minute Increments*