Boarding Information

Anclote Animal Hospital♦ Phone (727) 934-0814♦ Fax (727) 938-7610
1840 Alternate 19 South♦ Tarpon Springs♦FL♦34689

Dates of Boarding:  From_________ to _________. Estimated time of pickup(circle): 7:30am-10am   11am-2pm   3pm-6pm   unsure

Client Name: _________________________  Spouse/Partner:_________________________

Phone #'s where we can reach you while your pet is boarding: __________________,  _________________

Local Emergency Contact: Name: ______________________  Phone #'s________________, ___________________

**This is someone that you have authorized, and who agrees to make medical decisions for your pet(s) in the case where

   we can not contact you while your pets are boarding with us .

Boarders:

1. Patient name:_________________

    Grooming: (circle):  Bath  or  Professional Groom or none

    Doctors consultation (such as vaccines)?  Yes  No  Specify:________________________________

    ***It is recommended that you schedule a consult with the Doctor at time of drop-off or pickup so that you may speak with them in

          person and we can best care for your pet

    Diet::  (circle):  Kennel food  or  I brought my diet from home 

           Feeding instructions: Amount:_________  (circle) once a day  twice a day  free feed

    Prevention:  Flea/tick prevention applied within 4 weeks (circle) YES  NO  If no, an application of Frontline will be applied at a lesser cost

Please note any other specifics that can help us care for your pet while they are staying with us_______________________________________

2. Patient name:_________________

    Grooming: (circle):  Bath  or  Professional Groom or none

    Doctors consultation (such as vaccines)?  Yes  No  Specify:________________________________

    ***It is recommended that you schedule a consult with the Doctor at time of drop-off or pickup so that you may speak with them in

          person and we can best care for your pet

    Diet::  (circle):  Kennel food  or  I brought my diet from home 

           Feeding instructions: Amount:_________  (circle) once a day  twice a day  free feed

    Prevention:  Flea/tick prevention applied within 4 weeks (circle) YES  NO  If no, an application of Frontline will be applied at a lesser cost

Please note any other specifics that can help us care for your pet while they are staying with us________________________________________

3. Patient name:_________________

    Grooming: (circle):  Bath  or  Professional Groom or none

    Doctors consultation (such as vaccines)?  Yes  No  Specify:________________________________

    ***It is recommended that you schedule a consult with the Doctor at time of drop-off or pickup so that you may speak with them in

          person and we can best care for your pet

    Diet::  (circle):  Kennel food  or  I brought my diet from home 

           Feeding instructions: Amount:_________  (circle) once a day  twice a day  free feed

    Prevention:  Flea/tick prevention applied within 4 weeks (circle) YES  NO  If no, an application of Frontline will be applied at a lesser cost

Please note any other specifics that can help us care for your pet while they are staying with us________________________________________