Boarding SheetName(Required) First Last Email(Required) Patient Name(Required)Date In(Required) MM slash DD slash YYYY Date Out(Required) MM slash DD slash YYYY BreedSex(Required) Male FemaleAny Seizures or Reactions?(Required) Yes NoDiet Own Food Kennel FoodIf own food please write brandAmountIf multiple pets, can your pets eat together/ board / yard time together? Yes NoDuring your pets stay, if they have loose stool due to stress colitis may we give your pet a bland diet? Yes NoWhat your pet can have? Chicken Rice Pumpkin ProbioticSelect all that applyUntitled(Required) Additional charges may be appliedPlease provide all medications that your pet is currently on to the receptionist upon arrival List Medications:List Items brought with your pet & description of items: Untitled(Required) I also understand that Southside Inn & Suites is not responsible for any lost belongings or toys, or any damaged belongings or toys during my pet’s stayDoes your pet have any current medical concerns? Yes NoSpecial Instructions* Please schedule with receptionist at drop off (Appointments are limited)*Wash-N-Go (K-9)This consist of shampoo w/ towel dry onlyComplimentary with 5 nights or more*NOT OFFERED DURING HOLIDAYS/HIGH DEMAND WEEKENDS*Pets are checked In/Out during normal business hours: Monday-Thursday: 7:30am-12:30pm & 2:00pm- 5:00pmClosed: 12:30-2pm LunchFriday: 7:30am-12:30pm & 2:00pm-3:00pmIf someone other than the owner is picking up pet, they must be listed below.In case of an emergency and owner is not able to be contacted, please contact:Name(Required) First Last Phone(Required)I authorize my pet to be transferred to Southside Animal Hospital, to be treated as necessary, and to do whatever is necessary should any emergency occurs. If it is necessary to use sedation for treatment or handling, I give my permission to administer medications at my expense. I understand and agree that neither Southside Inn and Suites, Southside Animal Hospital, nor its employee’s will be liable for any illness, injury, death, and/or escape of Owner’s pets (s) provided that reasonable care and precautions are followed, and Owner hereby releases Southside Inn & Suites, Southside Animal Hospital, and employees of any liability of any kind whatsoever arising from or as a result of Owner’s pet (s) attending our facilities.Signature(Required)Date(Required) MM slash DD slash YYYY Phone(Required)Δ
