Please print and fill out the following documents.  Bring in with your pet at time of check in.

 Boarding Instructions

 Arrival date__________        Departure date__________

 Pet’s Name__________________________ Breed________________Color_______________

 Clients Name______________________________Phone______________________________

 Emergency Contact Person_____________________________________________________

 Emergency Number_________________________Other______________________________

 Items brought by owner         ___________________          ____________________

  _____________________      _____________________      ____________________

 FOOD             ______Has own food               ______Use Clinic Food           ______Free Feed

 Feeding Instructions:_________________________________________________________

 BEHAVIOR AND/OR ROUTINES:

 _____Good nature/friendly                   _______Use Caution               ______Warning/will bite

 __________________________________________________________________other behavior

 MEDICATIONS:                  _______None

 ______________________Medication_________________________Medication Instructions

 ________________________Medication_________________________Medication Instructions

 ________________________Medication_________________________Medication Instructions

 I hereby authorize that I am the owner of the above named animal(s) or I am responsible for the above-mentioned animal and have authority to execute this consent.

 I hereby authorize any medical treatment the veterinarian on duty see needed while my pet is in WRVC care.

 __________________________________________                                    ____________Date

Owner/Responsible Person

 Pet checked in by___________________Pet taken to kennel by________________________