Boarding Policies And Pet Medication Log (Dog Boarding Information Form) Page 2

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Kansas City Veterinary Care, L.C.
Dog Boarding Information Form
Pet Name: ____________________________________________
Additional Instructions:
□
Please board with my other pet: ____________________________
Owner Name: _________________________________________
□
Please bathe my pet:
Regular
Shedless
Medicated-list below
Breed: ________________ Age: ____________ Male/Female
□
Single Service:
Toe-nail trim
Ear Cleaning
Anal glands
Color: _____________ Boarding From _________ To ________
□
Special Needs-please specify below:
Feeding Instructions:
□
Other-please specify below:
What kind of food? We commonly stock:
□
□
How Often:
Maintenance
Fish & Potato
□
□
□
Once a Day
W/D
Duck & Potato
□
□
□
Twice a Day
I/D
Urinary SO
□
□
Lamb & Rice
DCO
□
□
Puppy/Growth
Other: _______________________
Stool:
□
Boarder Observations
□
Senior
Own: _______________________
1. Normal
Date
□
Light
□
2. Soft
Can_______________________
Stool
3. Diarrhea
How much should we feed your pet?
Meals
4. None
□
□
□
Meals:
Attitude
¼ cup
1 cup
+ ¼ cup
1. All
Vomit
□
□
□
½ cup
2 cups
+ ½ cup
2. Some
□
□
□
Walking Log
3. None
¾ cup
3 cups
Other: _________________
Date
AM
PM
Date
AM
PM
Attitude:
Personal Items:
Please list any personal items your
1. Excellent
2. Good
pet will have while boarding with us.
3. Fair
4. Poor
Vomit:
1. None
2. Bile
3. Food
Playtime:
For Kennel Use:
□
□
□
Bathe on: ____________________
Capstar on: ___________ Done by: ___________
□
Once a Day
15 min.
□
□
□
□
Sunday pick-up: _______________
Weight: ______________ Done by: ___________
Twice a Day
30 min.
□
□
□
□
Surgery on:
_________________
TNT and ear check
Done by: ___________
Every Other Day
Extra Walk
*There is an additional charge for playtime.
Emergency Contact Number: _____________________________________
Signature: ______________________________________________

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