Boarding Check In

Boarding Admission Form
By clicking here, you agree that you understand that completing this form does not reserve a kennel for your pet. You must call our office at (419)841-4745 to make a reservation *

Yes, I agree
Please fill out the following form and click "Submit" when finished before the date of your Check-In to help ensure a more efficient check-in process.
Reservation Details
Owner's Full Name *

First Name Last Name
Pet's Name *
Check-In Date *

Month Day Year
Check-Out Date *

Month Day Year
Emergency Contact *

Area Code Phone Number
Emergency Name *

First Name Last Name
Would you like us to send complimentary text messages while you are away? *

Yes No
Phone Number for text messaging

Area Code Phone Number
E-mail
Feeding Information
We recommend that you bring your pets normal diet in with you to avoid any upset stomachs. For convenience, it is acceptable to premeasure the food.
What type/brand of food does your pet eat? *
How much food do you feed your pet? *
How often do you feed your pet? *
Additional comments:
Medications
We are happy to give your pet his/her medications at no additional charge.

Please list any medications your pet will need / is currently taking along with dosages and how often they are given.

Also, please list the reason the medication was prescribed.
Medications
Playtime
All pets will receive a minimum of one-half hour of playtime twice a day. If they get along well with other dogs they can play in supervised groups. If they do not, they will get individual play time with one of our boarding staff.

Please answer the following questions about your pet.
Does your dog play well with other dogs? *

Yes No, if so disregard further questions
Does your dog play well with

Male Dogs Female Dogs Both
How does your dog react to other dogs when he/she is on a leash? Off a leash?
Has your dog ever bitten another dog or person?

Yes No
Allergies

Special Notes
Please list any allergies or specific medical needs. If none, please type, "none" in the space provided.
Can your dog have peanut butter?

Yes No
Can your dog have cheese?

Yes No
Cancellation Policy
If you make a reservation for your pet to stay in our boarding facility you have 24 hours prior tothe drop off day to notify our staff of your cancellation. If you fail to notify us about yourcancellation and do not show for your reservation you will be charged a fee equal to one nightof stay.

For dogs: $32 for one dog and if your reservation included two dogs the charge would be $55 For cats: $15 dollars per cat condo you had reserved
I understand West Suburban Animal Hospital's Cancellation Policy *

Yes, I Agree
Boarding Release Form

& Social Media Consent
West Suburban Animal Clinic

Boarding Release Form

Medications: If your pet will be receiving medication during his or her stay, it must be in the original veterinary-labeled containers with instructions for administration.

Vaccine Requirements: In order to protect the health of your pet, this facility requires documentation showing that all pets are current on vaccinations. Pets that are so young that they have not completed their entire series of vaccinations may not yet be protected and, thus, owners accept any risks of infection. Vaccines are required as followed:

Dogs: Must be current on the DHPP and Rabies vaccine within 3 years. They also must be current on the Leptospirosis vaccine, Bordetella/ Kennel Cough vaccine, and have a negative stool sample within 1 year.

Cats: Must be current on the FVRCP and Rabies within 3 years.

Statement of Kennel Policy

1. Pets must be picked up between 8 a.m. and 6:30 p.m. Mondays through Thursdays, 8 a.m. and 5:30 p.m. on Fridays, and 8:00 a.m. and 11:30 a.m. on Saturdays. Pick-ups and drop-offs are not available on Sundays or holidays.

2. This facility cannot guarantee the health of any animal, but pledges to provide appropriate care to all boarders. I agree to hold this facility harmless for conditions that often are unavoidable in boarding environments, including, but not limited to, weight loss or gain, rough hair coat, kennel cough, upper respiratory infection, diarrhea, and fleas.

3.If my pet identified on this record should become ill, I request that West Suburban Animal Hospital provide all medical/surgical treatment it deems necessary, with fees not to exceed $_____________. I acknowledge that in the event of my pet’s illness, the staff may not be able to contact me immediately. Nonetheless, they are authorized to initiate appropriate treatment until my agent or I can be reached. I agree to pay all related expenses associated with the treatment of my pet until I am available to discuss further care and related fees with the attending veterinarian.

4. If pets are boarding in the same kennel we reserve the right to separate if problems arise.
What is the max amount you would like to spend if an emergency occurs and we are not able to contact you? *
West Suburban Animal Hospital has my permission & the right to take photographs of my pet, and to copyright,use and publish the same in print and/or electronically. *

Yes, I agree No, I do not agree
By clicking here, you agree that you've read the above & are in full agreement. *

Yes, I agree
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Boarding Admission Form

Reservation Details

Feeding Information

Medications

Playtime

Allergies

Cancellation Policy

Boarding Release Form