Boarding Form

Please fill out the following form before your scheduled boarding date. If you have any questions, please don’t hesitate to call us at 336-835-1082.

Client's Name *

First

Last

Email *

Today's Date *

Pet's Name *

Breed *

Color *

Do you have additional pets?

Date to Be Picked Up *

Primary Contact Number *

Secondary Contact Number

Tertiary Contact Number

Name & phone number of responsible party in case of emergency while boarding: *

Are you leaving: Food? *

Are you leaving: Toys? *

Are you leaving: Bedding? *

Description of above materials

Special instructions or services while boarding

All cats/dogs must be clear of fleas, parasites, and current on Distemper, Rabies, Bordetella, and Canine Influenza vaccinations.
If medications are necessary for treatment, I give my permission to administer such medications. (Please note, there is an additional charge for this service)
Reasonable precautions will be used to ensure the safety and health of your pet while boarding. I authorize the doctors and staff at Animal Ark Veterinary Hospital to do whatever is necessary in case of illness or an emergency situation for the care of my pet.

Initials here if you acknowledge the above terms. *

Signature of Owner or Responsible Party *

Clear Signature

Ready for a visit?