amc-la / Pet Resort Admission Sheet

ANIMAL MEDICAL CENTER OF LEHIGH ACRES

BOARDING ADMISSION SHEET

Owner’s Name_________________________ Pet’s Name____________________________

Emergency Contact_____________________ Emergency Phone #_____________________

Pets are fed Science Diet Adult maintenance food or Purina EN. If your pet is on a Prescription diet it is recommended that you bring it in with them or it will be dispensed at the regular charge.

Any and all personal items, including food containers MUST BE LABELED UPON ADMISSION. You may bring personal items such as blankets AT YOUR OWN RISK, as they may get soiled, bleached, damaged or misplaced in the cleaning process.

There is an additional charge of $1.00-$2.45 a day for administration of medication.

All medications must be in their original container with a label that is legible. Any controlled medications will be counted at check in and discharge to insure accuracy.

Boarding Requirements:

All pets must have been examined by a certified veterinarian within the past year.

All pets must be up to date on DHPP (dogs), FVRCP (cats) and Rabies vaccination.

An approved Flea/Tick product applied within the last 30 days (Frontline Plus, K9 Advantix and Revolution).

A negative fecal examination within 6 months.

Dogs must be current on Bordatella (kennel cough) vaccination.

Frontline Plus is applied at owner’s expense if indicated.

Charges accrue on a per night basis.

I acknowledge that no guarantees have been made except reasonable precautions against injury, escape or illness. Should above animal become sick or injured during the stay he/she will be treated by the veterinarian on duty and I am responsible for charges. Should an emergency arise the owner/agent will be contacted at the above phone number.

OWNER RELEASE:

I have read and understand the information above. I understand that full payment is due at the time of discharge. If above animal is not picked up within 10 days of scheduled discharge date, said animal is assumed abandoned and Animal Medical Center is authorized agent for animal.

__________________________________ ________________

Signature of Owner/Agent Date

Check-out Time: ______ Sunday Check-out 9 -11:00am ($20.00 non-refundable fee) _______________

Playtime Options

We offer a number of additional services to enhance your pet’s enjoyment while staying with us. Please ask our boarding staff if you have any questions or special requests! If your pet stays with us for 7 days or more they will get a complimentary bath.

	Service	Price	Quantity or Daily	Owner Initial
Dogs:	Playtime w/ brushing (15 minutes)	$8.00
	Extra walks (3) 5 min sessions	$8.00
	Greenies (each)	$1.00 to 4.00
	Frozen Treats (each)	$2.20

	Service	Price	Quantity or Daily	Owner Initial
Cats:	Playtime w/ brushing (15 minutes)	$8.00
	Greenies bag	$2.99

Owner declines any extra services: _____________

Owner Initials

Form - Boarding Admission Sheet Form

Name (required)
First Name (required)	Last Name (required)

Pet's Name, Breed, & Current Weight (required)

Emergency Contact Name & Phone Number (required)

Cat Extra Options if any & how often (if not please state no) (required)

Dog Extra options if any & how often (if not please state no) (required)

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