Email (This should be the main email you would like us to use for your account) (required) Dog's Name (required) Owner's Name (That account is under in our system) (required) Is this a cell phone that can accept text message reminders from us? Yes No
In case of an emergency, we need a contact RESPONSIBLE FOR MAKING DECISIONS. Please provide a name, relationship to owner, and a phone number. This person can be yourself if you will be reachable. Name of person (and relationship if applicable) (required) Contact phone number (required) Will you be reachable by email for general questions? Yes No
We offer play sessions with other boarding dogs or our veterinary staff dogs as time and your dog's temperament allow. Would you like your dog to be ALLOWED PLAYTIME with our dogs? (required) I DECLINE playtime with other dogs for the safety of my dog or other boarders I would like my dog to be ALLOWED PLAYTIME with other dogs as time and temperament allow. I understand all reasonable efforts will be made to ensure all boarding pets safety, but accept the unpredictable nature and potential rick of play session with other dogs and will not hold Spring Green Animal Hospital liable for injury of my pet.
QUESTIONS ABOUT YOUR DOG
Please answer each question with Yes or No. If yes, please explain in text area below questions. Does your dog have any chronic or recurrent health problems we should be aware of? (required) Yes (please describe below) No Has your dog had recently or currently have any vomiting, diarrhea, coughing, sneezing, diarrhea, or other current illness? (required) Yes (please describe below) No Is your dog allergic to any medications? (required) Yes (please describe below) No Please describe here if you answered yes above.
Will you bring your dog's food? (It is recommended to bring their own food to prevent stomach upset from a diet change) Yes No If you do NOT bring your dog's normal food, we will feed Royal Canin Gastro-Intestinal Diet to try and prevent and GI upset due to diet change or stress. If your dog requires canned food, there may be an additional fee. Please provide feeding instruction. We are able to feed your dog up to 3 times a day (Morning, Midday, Evening) Be specific for amounts (ie. 1 1/2 cups) and time (ie. AM and PM). If you 'Free Feed' your dog, please provide us with the average amount of food your dog would typically eat in a 24 hour period. This is to ensure they are eating.
Does your dog require any medications? (required) Yes No If Yes, please provide us with the name of medication and instructions.
ANXIETY AND STRESS
Despite our best efforts to provide a comfortable, quiet environment for pets to stay while their owners are away, some pets become overly anxious while in a boarding setting. Because you are boarding your pet in a veterinary setting, we have the ability to prescribe and administer anti-anxiety medications, as well as mild sedatives. If your dog seems overly anxious or stressed while boarding: (required) I WOULD LIKE a trial of anti-anxiety medications (+/- a mild sedative). PLEASE CONTACT ME (I will be reachable) prior to prescribing an anti-anxiety (+/- mild sedative). I understand there is a chance for self-trauma if medication is not used or I am not reachable to ok the use. Sometimes a dog's reaction to stress in boarding can be shown by loose stool/diarrhea. I understand if this happens, my dog will be started on anti-diarrhea medications. There is an additional cost for this. (required) Yes
I understand that if my dog is not up to date (or current previous records can not be provided) on any of the required services (listed above), they will be performed during my dog's stay. There is an additional cost for this. (required) Yes Are there any other veterinary services requested during your dog's stay? Please describe. (ie. Heartworm test, Heartworm + Tick Disease test, Preventatives needed, etc.) We authorize SGAH to contact our primary veterinarian for medical records. (required) Yes
Do you have any other comments or questions about your dog while they are here?
If any problem is observed or develops: Please treat my dog as required (ie. Laceration, Ear or Skin Infections, etc.) Perform ONLY Emergency and supportive care. Contact me/my emergency contact first before providing any other treatment.
I UNDERSTAND AND AGREE:
• Should an EMERGENCY arise, I authorize the staff of Spring Green Animal Hospital (SGAH) to sedate and/or perform such emergency procedures as may be necessary for the health of my pet until I can be notified. • I agree to pay, in full, all charges for necessary services rendered for and to my pet. • I will not hold the clinic responsible for conditions that, despite all our best efforts, can occur while boarding, such as but not limited to weight loss, hair loss, upper respiratory infections, bronchitis, diarrhea, fleas, etc. • SGAH is not responsible for loss or damage of personal items left with the pet including but not limited to leashes, collars, toys, and bedding. • SGAH will use all reasonable precaution against injury, illness or escape of my pet. SGAH will not be held liable if injury or escape occurs. • SGAH will not be held liable for problems that develop provided reasonable care and precautions are followed. I will call if my “pick-up date” changes so you can plan accordingly. If I neglect to pick up my pet within 5 days of the date scheduled for discharge and do not notify Spring Green Animal Hospital within that time period, you may assume that my pet is abandoned and are hereby authorized to re-home as you deem best. DIGITAL SIGNATURE (Type your name) (required) Date (required)