Canine Boarding Admission Form - Arden Animal Hospital

Arrival Date (required) :

Departure Date (required) :

Dog Size (required)

Small Dog (1-25lbs) $43.50
Small Dog with Rx $59.75
Medium Dog (26-50lbs) $48.50
Medium Dog with Rx $65.00
Large Dog (51-100lbs) $53.75
Large Dog with Rx $70.25
Bath (not given Sat-Mon. Prices may vary depending on hair coat) $51.50-$64.25

Boarding Requirements

Current Vaccinations - check if needed (required)
Influenza Vaccine $48.90
Current/Up to Date (Influenza)
Rabies Vaccine $42.50
Current/Up to Date (Rabies)
DHPP Vaccine $42.50
Current/Up to Date (DHPP)
Bordetella Vaccine $42.50
Current/Up to Date (Bordetella)

Intestinal Parasite Examination* (by fecal flotation) (required)
Within one year $77.60
Current/Up to Date

Physical examination (required)
By one of our Veterinarians within the past 12 months if your pet is on medication $75.00
Current/Up to Date

Please Read:

Fleas

If your dog has received vaccines, flea treatment, or had a parasite exam at another veterinarian’s office, we need a copy of your dog’s medical records from your vet’s office as proof.

Diet (select one) (required)

Hospital Diet (The Veterinarian’s choice of a bland diet. Hills Science Diet Sensitive Stomach Dry and Canned is available)
Own Diet (There is no additional or decrease in cost if own food is provided)

Amount and frequency of diet to be given (required)

Medications: Please provide the name of medication, dosage, and frequency of medication to be given

Has your pet had its medication today?

Yes
No

Do you need a refill of your medication(s) for your dog?

Yes
No

If yes, which medications need to be refilled:

Arden Animal Hospital is not responsible for any items left with your pet.

Items Left: (Items left with your pet are left at your own risk. Each item must be labeled with you

Emergencies

Financial limit for emergencies (if any):

Emergency Contact Name/Numbers (required)

Discharge

I have read all of the above and I am in full agreement. (required)

Yes
No