Canine Boarding Form

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Canine Boarding Form

Completing this form prior to your arrival will permit us to spend additional time reviewing your current concerns as the history will already have been completed.

Client Name

First Name:

Last Name:

Phone:

Alternate Contact Name

Alternate Contact Phone

Check if alternate is picking up pet Yes No

Check in date

Check in time

Check out date

Day of Week of Check out

Est. Pick Up Time (there is a late pick up fee of $10.50 for picking up after 3PM)

Pet Information

Name

Alone or sharing kennel with:

Standard Boarding Services Provided

Three exercise periods per day, lots of love, feeding sensitive stomach and skin, veterinarian supervision, licensed veterinary technician monitored, administration of medications and/or supplements

Daily Boarding Rates (we require a clean-up bath for a stay longer than one night, $15.00):

Clean-up Bath, $15.00

Feeding

If bringing food from home, please provide in a clearly marked container.

***If your pet runs out of the food you provided while boarding: If it is a food CHFA stocks, we will open a new bag/can(s) and invoice accordingly. If it is not a food CHFA stocks, we will feed your pet Science Diet Sensitive Stomach and Skin, at no additional cost.

Food: Use CHFA food Brought food Purchased food

If not CHFA provided food, please name food:

Amount per feeding

Dry Qty per feeding:

Wet Qty per feeding:

Frequency of Feeding

Next Feeding Due:

Optional Packages & Services

***Rawhides and dental chews are available for in-store purchase***

Fur-Get Me Not $3.25/day

Date(s)

Doggie Daycare Stay & Play Package $13.75/day

Date(s)

Email (Required for the Fur-Get Me Not & Stay & Play packages):

Text Message Number (Required for the Fur-Get Me Not & Stay & Play packages):

Extra Stretch The Legs Walk $4.75/time

Fifteen-minute Brushout $16.00

Thirty-minute Brushout $32.00

Nail Trim $14.75

Ear Cleaning $17.50

Anal Glands Expression $28.75

Pre-Scheduled Services

I have made arrangements with Shaggy Pines

Date(s)

I have made a Grooming Appointment

Date(s)

With: Megan Michelle Aggie Brittney

Additional Information

If you have additional instructions for your pet's stay, please list them here. If instructions are additional services, you will be charged appropriately for them.

If your pet has any extra medical needs that would require specialized one-on-one attention, please list them here. There will be a fee discussed at time of check-in while meeting with a Veterinary Nurse.

Authorization of Non Life-Threatening Treatment

I authorize Cascade Hospital for Animals to treat any unexpected non life threatening medical problems such as lameness, skin infections and ear infections up to $150. If we cannot complete the services under this amount, no services will be performed until we receive your approval first No Yes

My pet will require a doctor examination &/or insulin ($8.25 once daily, $16.50 twice daily) while boarding (separate form with owner instruction is needed for this service, and original containers for all medications and injections)

Please Confirm

Thank you for your submission!

CASCADE HOSPITAL FOR ANIMALS

6730 Cascade Road SE.
Grand Rapids, Mich. 49546
616-949-0960

Monday-Thursday 7:30 am – 7 pm
Friday 7:30 am – 6 pm
Saturday 8 am – 5 pm
Sunday 10 am – 5 pm

BRETON VILLAGE ANIMAL CLINIC

1852 Breton Road SE
Grand Rapids, Mich. 49506
616-988-4980

Monday-Friday 7:30am – 6 pm
Saturday 8 am – 1 pm
Sunday Closed

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