BOARDING ADMISSION FORM
Westwood Animal Hospital  

Vaccinations required within the past 12 months. Dogs: Rabies, DA2P-PV, Bordetella (Kennel cough)   Cats: Rabies, FVRCP
All pets are required to be flea and tick free. 
They must have had a stool sample examined for worms during the past 12 months.
**Should any parasites be found, treatment (at normal hospital rates) will be performed.**
Number Special Care Package:    
-One play period each day
-Treat each day
[ ] Daily  [ ] Every Other Day
[ ] Other: _______________

Please ask the receptionist for fee
Cages: Cats, rabbits, ferrets (single pet)
Cats (two pets per cage)
Dogs, small		 [      ]
[      ]
[      ]
Runs: Dogs  (single) [      ]
Shared Run: Dogs (two pets) [      ]
Sunday Pickup (prearranged for 6 pm, only) [   ]  Additional fee - please ask
BOARDING INFORMATION:
Owner's name: _________________________________ Pet's Name:________________________________________ 


Date in:  _____________   M T W Th F S  AM PM    Date out:  _____________   M T W Th F S Sun AM PM

Belongings:  Collar: _______________________ Leash:_______________________ Towel:_______________________ 

Blanket:_________________________ Carrier:_______________________ Other: ______________________________                                                

Special diet information:  _________________________________________________________________

Medications:  ___________________________________________________________________________ 

Has your pet received AM Meds? Yes / No.   PM Meds? Yes / No

Other information:  _____________________________________________________________________________________

Additional Services
DA2PP Vacc Fecal exam Dentistry Bathing ____/____/___date
FVRCP Vacc Heartworm Test Obedience Tattoo
Rabies Vacc Physical examination Healthy Pet Pkg. Other______________

  Protect your pet with an AVID© FriendChip - Micro chip ID    Can be safely and easily implanted while your pet boards
Boarding authorization :I authorize Westwood Animal Hospital to board and care for the above named pet(s).  Should a medical or emergency situation occur, I authorize whatever treatment is necessary and will remain fully responsible for the cost of all services provided.  If I neglect to pick up the above named pet(s) within 5 days of the discharge date indicated above, you may assume this pet has been abandoned and will become the property of Westwood Animal Hospital.  
Signature of owner/agent:  X____________________________  Emergency Ph No:___________________________

While you are away, we will insure your pet has an enjoyable stay!!

 

S

M

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appetite

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

am

stool

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

am

appetite

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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stool

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

pm

Appetite [G = good,  P = poor,  O = didn’t eat]                        Stool [N = normal,  S = soft,  D = diarrhea,  O = none]