Boarding Intake Form

Client Info

Patient Info

Has your pet(s) been exhibiting any unusual signs or symptoms (sneezing, coughing, upset stomach, etc.) that we should be aware of during your pet(s) stay with us?
Are there any special exams (ears, eyes, skin, etc.) that need to be performed on your pet(s)?

Services

Grooming Services:
Regular Bath includes (Bath and Brush Out Only). The Works Bath includes (bath, brush out, anal gland, expression, nail trim, and ear cleaning.) Full-Service Groom includes (the Works Bath and full body haircut or shave down. Add-ons (extra charges apply) De-shed ($17.33 to $27.83) Soft-claws application ($17.33 to $27.83) Toothbrushing ($12.08)
Veterinary Services:
Will you be leaving food for your pet(s)?
(If a special diet needs to opened, the food will be added to your bill)
Are there any medications that need to be given during your pet(s) stay (additional charges of $6.00 per day for administering medications)?

In case of illness or injury, I the undersigned, do hereby give my consent for the veterinarian(s) of East Dallas Veterinary Clinic (the Hospital) to treat, prescribe for, or operate upon my pet(s) while they are being boarded at the Hospital. I understand that every effort will be made to contact me prior to any procedures being performed but emergency and/or necessary treatment will not be withheld if contact is not made. Any pet(s) not currently vaccinated (including Bordetella for dogs) or that is infected with parasites (including fleas and ticks) will be treated at an additional expense. The Hospital is to use all reasonable precautions against illness, injury or escape of my pet(s), but the Hospital will not be held liable for care or treatment that are beyond its control. I agree to allow my pet(s) previous records to be released as needed for my pet(s) stay at the Hospital. All pets may be picked up anytime during our regular business hours. If your pet(s) will receive a bath upon discharge, please plan to try to come later in the day so that he/she has time to dry. Thank You!

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