Boarding Questionnaire

MM slash DD slash YYYY
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Approximate pick up time:(Required)
Food Type:(Required)

(We use Science Diet in hospital if you do not provide food for your pet)

Dogs must be current on: DHPP, Bordetella and their Rabies vaccines. K9 Influenza and Corona vaccines are recommended.
Cats must be current on: FVRCP and Rabies vaccines. Feline bordetella is recommended.

Is your Pet on medications:(Required)
* There will be an additional $20 charge per day for medication administration *
Would you like your pet to receive a doctors exam during their stay ($50 dollar charge)(Required)
Would you like the following (additional charges will apply):
Fecal exam?(Required)
Routine Dewormer?(Required)
Toe nail trim?(Required)
Flea prevention?(Required)
Heartworm Test?(Required)
Express Anal Glands:(Required)
Bath before going home:(Required)
(Please allow time for your pet to dry before pick-up)

Personal items may be left at your own risk! We are not responsible for lost or damaged items! Upland Animal Hospital does not guarantee the health or life of any animal during its stay. Certain conditions may arise at any time that not only are unavoidable in boarding environments, but also for the most part will be beyond our control. If your pet becomes ill during its stay, we will make reasonable efforts to contact you by phone. If we are unable to reach you, we will do what we can to preserve your pets health or life, and fees will be charged accordingly. Please note that dogs will be placed in appropriate sized kennels at our discretion. Veterinary services will be unavailable during closing and some weekend hours.

I agree to hold Upland Animal Hospital harmless and to relieve this facility of any liability in the event of a disease, accident, injury or death affecting my pet during or after its stay.