Boarding Form | Williams-Sebby Vet Clinic & Pet Resort

Client's Name*

First Last

Animal(s) Name(s)*

Email*

Phone*

What type of animal will be staying with us?*

Canine
Feline

To the best of your knowledge, is your pet up to date on his/her shots?*

Rabies (Canine/Feline) *Required
Bordetella (Canine) *Required
DHLP-PV (Canine) *Required
Influenza Combo (Canine) *Required
Heart worm test/Occult (Canine)
FVR-CP (Feline) *Required
FELV (Feline)

If you are a first time client, please email (or have your vet email) a record of your shots to Williams-Sebby Vet Clinic before your boarding dates*

I am a new client and will have my pets shot record sent over.
I am already a client of Williams-Sebby Vet Clinic.

What dates will your pet be boarding with us?*

Has your pet been sneezing or coughing?*

Yes
No

In case of an emergency, who should we contact? Please list emergency contact's name.*

Emergency contact's phone number*

Please list your pet(s) belongings. Note: All belongings should have your last name listed somewhere on it. Beds/Blankets are washed on a daily basis.*

If bringing own food, please separate dry food in ziplock bags so they get the right amount of food. If bringing canned food, please write a detailed discribtion of how much they get at feeding and how often.*

I have separated my pet’s food out and written a discribtion for staff.
My dog will be eating Clinic Food

Please list any medications that your dog is taking, how often they need to take it, the amount and if they need to take it with food.*

If pet medication requires a pill pocket, please provide the pill pockets or we can provide them at an additional cost*

I will provide pill pockets.
I will pay the additional cost for pill pockets
My pet does not require a pill pocket for medication
No medication required

Is your pet on Heartworm Preventative?*

Yes
No

Is your pet on Flea Preventative?*

Yes
No

Would you like Extra walks for your dog? ($3.50 extra for each walk)*

Would you like Extra Play for 7-10 minutes ($6.50 extra per extra play).*

Would you like swim time for pet, 10 minutes each time? (Swim time is Seasonal and is $11.00 per swim).*

Would you like Pupsicles? (One a day, Sesaonal, $5.00 each)*

Would you like to Rent a Kong? (Sesaonal, starts at $5.00)*

Would you like a bath at pick up? (At Check in, please let us know the time you will be picking up your dog*

All pets must be current on all required vaccinations. If not, we can give them the shots at drop off at clients expense.*

I understand and agree with the above statement
I do not agree with the above statement.

If your pet(s) have not been examined at WSVC before, we are required to establish client patient relationship.*

I understand and agre with the above statement
I do not agree with the above statement.

All pets must be free or external and internal parasites (i.e. ticks fleas, etc.) or they will be treated at the owner’s expense.*

I understand and agree with the above statement.
I do not agree with the above statement.

Williams-Sebby Veterinary Clinic has my permission to do whatever is necessary should an emergency arise with my pet*

I understand and agree with the above statement
I do not agree with the above statement

Your pets may be picked up between 7:30 a.m. and 5:45 p.m. Monday-Friday and before 12:45 p.m. on Saturday. NO EXCEPTIONS.*

I understand and agree with the above statement
I do not agree with the above statement

Estimated Drop Off Time*

If you pick up after 10:00 a.m. on any business day, you will be charged another day of boarding. Only exceptions are if your pet is being groomed or bathed.*

I understand and agree with the above statement
I do not agree with the above statement

Signature required at time of drop off*

First Last

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