Boarding SheetPet Name First Last Date In MM slash DD slash YYYY Date Out MM slash DD slash YYYY BreedMale or FemaleColorAny Seizures or Reactions? Yes NoDiet Own Food Kennel FoodBrandAmountIf 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 can your pet have? (Additional charges may be applied) Chicken Rice Pumpkin ProbioticIs your pet on any medications? Yes NoList Medications:*Please provide all medications that your pet is currently on to the receptionist upon arrival* Add RemoveItems brought with your pet: Add RemoveSpecial Instructions:Please schedule with receptionist at drop off (Appointments are limited) Wash-N-Go (K-9) - This consist of shampoo w/ towel dry only - Complimentary with 5 nights or more Feline Waterless bath (Complimentary with any amount of stay) Pets are released during normal business hours: Monday-Thursday 7:30am- 5:30pm / Friday 7:30am-4:00pm Closed 1-2pm LunchIf someone other than the owner is picking up pet, they must be listed below.Emergency Name First Emergency PhoneConsent 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.SignatureReset signature Signature locked. Reset to sign again Date MM slash DD slash YYYY PhoneΔ
