Boarding Reservation and Express Check-in Form

Name*

First Last

Have you used our boarding or hospital facilities before?*

(with this pet or any other pets)

Yes
No

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Phone number(s) where you may be reached while you are away*

Click on plus symbol to add additional phone numbers.

Emergency Contact Person*

This person should be someone that you trust to make decisions for your pet if we are unable to reach you (click on plus symbol to add additional names).

Name	Phone Number

Authorized for pick-up*

Would you like to authorize anyone, other than yourself, to pick up your pet from boarding?

Yes
No

Click the plus sign to add additional names.

Name	Phone

Boarding Office Hours

Monday to Friday: 9:00 am – 2:00 pm and 4:00 pm – 7:00 pm

Saturday and Sunday: 9:00 am – 2:00 pm

Please note: The boarding office is closed on holidays for drop-off and pick-up

Boarding Dates Requested

Drop-off Date*

Drop-off Time*

: HH

MM

Pick-up Date*

Pick-up Time*

: HH

MM

Pet Information

Pet's Name*

One pet per form. Please fill out another form for an additional pet.

Has your pet visited our boarding or hospital facilities before?*

Yes
No

What type of pet will you be boarding?*

Please choose one:

Dog
Cat
Other

What type of pet is he or she?*

Is there any important information we should know about your pet in order to make there stay as comfortable as possible?*

(example, existing medical/physical conditions, fear conditions, dog/cage or people aggression, etc.)

Yes
No

Please elaborate:*

Is your pet on medication?*

Yes
No

Medication (there is an additional charge of $2 per administration)*

Please fill out the medication section below. Click the plus symbol for additional medications.

Medication Name	Amount that you give	How often you give it

Feeding*

You may bring your own food, or we can feed your pet our in-house diet. We can also do a combination. NPAH feeds a diet that is easy on the digestive tract, which can be reactive to the stress of boarding.

If you bring your own food, please bring only the quantity we will be using. Dry food: Packaged in individual bags (one for each feeding). Canned food: Quantity of cans we will be using. This assures your pet gets the exact amount you feed.

Our Dry Food (Kennel's)
Our Wet Food (Kennel's)
Your Dry Food (Owner's)
Your Wet Food (Owner's)

Feeding Instructions*

How much do you feed? How often do you feed? Please be specific.

Does your pet have any food allergies?*

Such as peanut butter, beef, grains, etc.

Yes
No

What are they allergic to:*

Pet's Belongings*

We recommend that you leave your pet’s bed, toys and other belongings at home. Your pet’s area is cleaned and bedding changed multiple times throughout the day. We cannot guarantee that your pet’s belongings will not get lost during cleaning and washing due to the large amount of wash done each day. NPAH provides bedding and toys for all of our boarding pets.

I am not bringing belongings
I am bringing belongings

Belongings:

Describe in detail (color, size, etc.) Please remember, we can not guarantee the return of your pet's belongings.

Would you like your pet bathed, nails trimmed or flea/tick products applied while he/she is boarding?*

Because our boarders are walked outside, we cannot guarantee they may not come in contact with fleas or ticks. NPAH recommends a flea/tick product be applied to your pet before boarding with us.

Nails trimmed: $10.00 - $25.00
Flea/tick product applied: $12.00 - $25.00 dependent upon size
Dogs Only - Bath: $28.00 - $50.00 dependent upon size
None of the above is needed

Important Information for Pet Owners

1. Administration of medications and/or supplements will incur an additional charge.

2. If we find evidence of fleas or ticks on your pet, we will apply one dose of topical flea/tick preventative at an approximate cost of $12-$25, depending upon your dog’s weight.

3. We take every precaution to ensure that your pet’s stay is safe and they remain healthy. The stress of boarding can exacerbate underlying illness or cause stress illness in some pets. North Penn Animal Hospital is not responsible for the costs incurred by these illnesses.

4. Should your pet become ill or require emergency care while boarding with us, one of our doctors will examine your pet and prescribe medications as needed. We will attempt to contact you and/or your emergency contact if this becomes necessary. The examination and any prescribed medications or treatments will be charged to your account.

5. Dogs are required to have a license in the state of Pennsylvania. We are subject to random inspections by the Montgomery County Dog Warden. If your dog is not licensed, you may incur a fine. For more information on licensing, please visit www.padoglicense.com.

Authorizations

I authorize the doctors of North Penn Animal Hospital to perform emergency services/treatments for my pet, if necessary, during his/her stay. We will make every attempt to contact you and/or your emergency contact should an emergency arise.*

Yes
No

I authorize my emergency contact to make treatment decisions for my boarding pet in my absence and I understand that I will be responsible for any charges incurred.*

Yes
No

I have read and agree with the "Important Information for Pet Owners" and I understand that payment in full is due at the time of pet pickup.*

I agree
I disagree

Authorization*

Please enter name and date to authorize

Client Signature	Date

Additional Comments

Monday	8:00am – 8:00pm
Tuesday	8:00am – 8:00pm
Wednesday	8:00am – 8:00pm
Thursday	8:00am – 8:00pm
Friday	8:00am – 8:00pm
Saturday	9:00am – 2:00pm
Sunday	10:00am – 1:00pm

Contact Us

Boarding Reservation and Express Check-in Form