"*" indicates required fields Name* First Last Pet's Name* Owner's Phone #Check In Date* MM slash DD slash YYYY Check Out Date* MM slash DD slash YYYY Emergency Contact (Other than owner)* Emergency Phone #*Will we be able to contact you?* YES NO How do you prefer to be contacted?* **If you are out of the country or cannot be reached, you are authorizing Dr. Jeter to provide any necessary medical treatment for the well-being of your pet(s) which you, as the owner, will be responsible for.* Initials1. Veterinary care or vaccinations needed while boarding:*2. Is your pet currently on any medication?* Yes No If yes, details*3. Please describe any bedding, towels, toys, etc. you are leaving with your pet:4. Did you bring your own food with you? (House Food is $3/day) Yes No How many times a day do you feed your pet? How much? 5. Would you like for your pet to have any of the following before going home? Bath Special Shampoo? Nail Trim Dremel Anal Glands (If bathed on the day they are going home, EXPECT pickup between 3:00pm-4:30pm but you will be contacted when ready to go home) ***Dogs must be current on Rabies, Distemper/Parvo, Bordetella (within 6 months), and Canine Influenza. Records must be presented before boarding. Bordetella is required at Hilltop Dog Hotel every 6 months. Client understands that their dog is still at a low risk of contracting Bordetella virus due to mutations and strains not covered by the current vaccination. Client is responsible for getting previous vaccination records to Hilltop Dog Hotel before bringing a dog for boarding. If the dog is brought for boarding and is not up to date, Client agrees to have the dog vaccinated by Rocky Hill Animal Hospital and is responsible for fees. In addition, any animal found having fleas or evidence of a flea infestation will be given Capstar—a safe, proven flea control medication—to protect our clinic and other patrons for the cost of $9.00 (under 25lbs) or $10.00 (over 25lbs).Boarding Extra's (for an additional charge) Cuddle Time One-on-One Playtime with staff Nature Walk (1 dog at a time, once per day) Extra outside time QuantityCuddle TimeQuantityOne-on-One Playtime with staffQuantityNature WalkQuantityExtra outside timeSunday pick-up (scheduled) is from 4pm to 6pm only and the charge is $30 + tax. When Sunday pick-up, all charges must be pre-paid at drop off. Please leave # if you would you like to receive free text updates while your pet is hereSignature*Date* MM slash DD slash YYYY PhoneThis field is for validation purposes and should be left unchanged.
