Owner's Name *

First

Last

Phone

Email *

In case of an emergency, responsible party/agent (if different than above):

Name

First

Last

Phone

Pet Information

Pet Name

*Please note that we need a separate boarding form per pet.

Description

Date In / Time In *

Date

Time

Pick Up Date / Time *

Date

Time

The following are required annually for boarding; please verify at check-in what is due:

Need to do NOW:

Physical Exam
Fecal Exam
Blood Work

*Please check all that apply. Note: if this is your pet’s first time boarding, additional items may be required.

Services I request while boarding:

*Please check all that apply.

Please describe your pet's current diet: *

Has there been any illness or injury in the last 30 days? *

Yes
No

If yes, please describe the illness or injury: *

Is any medication required? *

Yes
No

If yes please list all medications, and when to administer said medications:

*Please note: there is an additional charge for daily medication administration.

At Camp GoldenView, socialization is key to our service and interaction may include individual attention, verbalization, lunch with our staff, exercise and games. *

I AUTHORIZE GVH staff to interact with my pet(s) in appropriate areas of the hospital
I DECLINE staff interaction other than feeding, cleaning, showers & weight checks.

Please let us know if your pet is accustomed to something particular at home and we will strive to maintain this continuity while he/she is here with us. *

Would you like to receive a text message with a picture* while your pet is boarding? *

Yes
No

Standard text message rates may apply. Check with your carrier.

Cell phone number for text message

Standard text message rates may apply. Check with your carrier.

Client Item Inventory Item & Bin #

I understand that in the event my pet becomes ill, the staff will attempt to contact me or my agent immediately to discuss the problem and treatment options. If I or my agent cannot be reached, I herby authorize GVH to initiate appropriate treatment until I or my agent can be reached. Should an EMERGENCY arise, I authorize the medical staff to sedate/anesthetize my pet and/or perform such emergency procedures as may be necessary for the health of my pet until I can be consulted. I agree to pay, in full, for all charges for necessary services rendered to my pet. In the event of death of my pet, I understand that the staff will immediately attempt to contact me. If I am unreachable, I understand that the body will be held until I return to discuss body care and disposition. I understand that the hospital is not responsible for loss or damage to personal items left with my pet, including, but not limited to, cages, dishes, toys, and bedding. I will call if my pick-up date changes so GVH can plan accordingly. If I neglect to pick up my pet within 5 days of the date scheduled for discharge and do not notify you within that time period, you may assume that my pet is abandoned and are hereby authorized to proceed as you deem best and/or necessary. OWNER RELEASE (only one signature needed for ALL pets left in our care for each boarding stay)

Signature

Boarding Admission FOrm

Online

Boarding Admission Form

Pet Information

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