Boarding Form

Your Name (required)

Your Pet's Name (required)

Your Email (required)

Boarding Dates (required)

Where you will be staying and phone number: (required)

Emergency Contact

Does your pet have health problems?
 Yes No

Does your pet require medicine?
 Yes No

Does your pet have allergies?
 Yes No

Is your pet on a special diet?
 Yes No

Will you bring your pet's own food?
 Yes No

Is your pet on a RX diet?
 Yes No

If you answered yes to any of these questions please explain:

Grooming/Bathing is available at Lance Animal Hospital for additional fees. Please check, if you would like your pet groomed or bathed prior to pick up from boarding.

Grooming:
 Yes No

Bath Only:
 Yes No

DeShed Process:
 Yes No

Grooming/Bathing Instructions or Special Requests:

Lance Animal Hospital retains the right to administer flea protection at your expense as deemed necessary for the control of fleas & other flea borne parasites within the boarding facility. Lance Animal Hospital maintains the highest standards of cleanliness and will not be held responsible for any parasite problems that may arise due to prior improper flea prevention.

Additional Playtime or outdoor time is available upon your request for additional fees
 Yes No

How many hours?

Other Services Lance Animal Hospital can provide during boarding for your convenience:

Nail Trim:
 Yes No

Cold Laser Therapy:
 Yes No

Dental:
 Yes No

Express Anal Glands:
 Yes No

VOM (veterinary orthopedic manipulation):
 Yes No

Massage:
 Yes No

Wellness Bloodwork:
 Yes No

Products needed at pick up Flea/Tick Control:
 Yes No

Heartworm Medication:
 Yes No

Food:
 Yes No

Rx Refill:
 Yes No

Owners Special Services Requests:

Canine Influenza Vaccine is now a requirement for boarding