Boarding & Admissions Form

Name: McFarland Animal Hospital
Address: 5620 HWY 51, McFarland, WI, 53558, United States
Telephone: 608-838-3400
Price range: $

APPOINTMENT

Thank you for giving us the opportunity to care for your pet. Please fill out this form as completely and accurately as possible!

Please note: A reservation is needed to board your pet. Please call us at 608-838-3400 to make a boarding reservation.

Name(Required)

First Last

Email(Required)

Pet's Name(Required)

Best phone number in case of emergency(Required)

Alternate best phone number in case of emergency(Required)

Drop-Off Date(Required)

There will be no Sunday or holiday pick-up or drop-off.

MM slash DD slash YYYY

Drop-Off Time(Required)

Pick-Up Date(Required)

There will be no Sunday or holiday pick-up or drop-off.

MM slash DD slash YYYY

Pick-Up Time(Required)

Pick-up after 11:00 am will incur a late pick-up fee of one night's boarding per animal.

Dietary Instructions

Food Type (select all that apply)(Required)

Canned

Dry

Own

Hospital Stock

Cups per Meal:(Required)

Frequency of Feeding:(Required)

Does your pet have any special feeding requirements?

Medications & Special Accommodations

Is your pet on any medications, including OTC medications:(Required)

Yes

Medication name:

Dose (in mg or ml):

Instructions:

McFarland Animal Hospital provides clean bedding, water, & food dishes which are changed daily or as needed. If you choose to provide your own bedding or bowls, please label your personal belongings with permanent marker and list all items in detail (shape, size, color, pattern, material, etc.) that you brought with your pet. We cannot guarantee against loss of damage of personal items during a boarding stay. Please include the description of any carrier, collar, harness, or leash that you are leaving with your dog or cat.

Do you have multiple dogs boarding?(Required)

Yes

Can they eat together?

Yes

Can they kennel together?

Yes

Can they go outside together?

Yes

Has your dog been given heartworm preventative in the last 30 days?(Required)

Yes

Has your dog been given flea & tick preventative in the last 30 days?(Required)

If evidence of fleas or ticks is present, appropriate medication will be given. A fee will apply for this service.

Yes

In the past week, has your dog experienced coughing, sneezing, vomiting or diarrhea?(Required)

Yes

Is your pet allergic to any drugs?(Required)

Yes

If yes, please describe:(Required)

Has your pet had any illness or injury in the past days?(Required)

Yes

If yes, please describe:(Required)

Optional Services available at an additional charge:

Nail Trim ($16.75)

Anal Glands ($23.75)

Ear Cleaning ($19.75)

Fecal Exam ($26.00)

Sanitary Clip ($18.75)

Medical services requested at an additional charge:

*If an exam is required, it is recommended that a drop-off appointment be scheduled in advance in order to ensure the availability of an appointment with a veterinarian.

Rabies vaccine

Distemper vaccine

Bordetella vaccine (canine)

Influenza vaccine (canine)

Ear swab & cytology

Urinalysis

Exam*

Describe your concern(Required)

I acknowledge that McFarland Animal Hospital requires that rabies and distemper vaccinations be required for all pets. Canine boarders must also be up to date on Bordetella vaccinations. Leptospirosis is highly recommended but not required. If proof of vaccines cannot be provided, MAH doctors will administer them and relevant charges will be applied to my account. Verbal confirmation of vaccination will not suffice for boarding.(Required)

I have read and understand.

I acknowledge that boarding drop off and pick-up hours are 8 am - 5:30 pm on Monday - Thursday and 8 am - 4:30 pm on Friday. Holiday hours will vary. Pets checking out after 11:00 am Monday - Friday will incur an additional fee equivalent to one night of boarding per pet.(Required)

I have read and understand.

I acknowledge that boarding reservations that extend beyond 14 days will be discounted by 10%.(Required)

I have read and understand.

I understand the balance for boarding and additional services is due in full at the time of pick-up.(Required)

I have read and understand.

I understand that boarding staff are not present 24 hours. Staff will take all precautions against illeness, injury, or escape of my pet(s). However, should the unforeseen arise McFarland Animal Hospital will not be liable.(Required)

I have read and understand.

I will call if my pick-up date changes. I understand that extensions made on a space-available basis and not guaranteed.(Required)

I have read and understand.

I acknowledge that McFarland Animal Hospital will attempt to contact me if unexpected medical attention is deemed necessary. If you are unable to contact me, I authorize the following:(Required)

Do whatever is needed for my pet until you are able to reach me.

Do whatever is needed up to a specific amount (specify below) you are able to reach me.

Do not do anything until you are able to reach me, even if my pet may die.

Specified amount:(Required)

Signature of Owner or Agent(Required)

Date(Required)

MM slash DD slash YYYY

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Name

This field is for validation purposes and should be left unchanged.