Hopi Animal Hospital - Scottsdale, Arizona

Boarding or Daycare Consent Form

Boarding form MUST be submitted at least 24 hours in advance of first reservation date. Please call and make your reservations for boarding prior to filling out this form. One (1) form per animal.

Reservation Dates :
Guest: Breed:
Color: Age: Gender Altered

Type of Accommodations you would like:

OWNER INFORMATION
Name:

Address:

City:

Phone:

Our business hours for drop off and pick up are Monday 7:30 am - 5:30 pm, Tuesday through Friday 7:30am - 6:30pm and Saturday 8:00am-2:30pm. Please note that we are closed on Sundays and major holidays.

Hopi Animal Hospital requires that all animals boarding at our facility are current on their vaccinations and flea/tick preventative. This includes:

Dogs:	Cats:
Da2ppv	FVRCP
Rabies	Rabies
Bordatella	FELV
Frontline	Frontline

Please note that if vaccination history information cannot be provided by the owner, or if the animal to be boarded is not currently vaccinated, Hopi's policy is for our vet-on-call to vaccinate that animal at the owner's expense.

Please list any toys you have brought: (Please keep your pet's leash to use upon arrival. We provide slip-leads to walk the animals.) ** Please be aware that Hopi Animal Hospital is not responsible for any toys that may get chewed or destroyed. Please have all belongings labeled with the pets name and last name. Thank you!

EMERGENCY CONTACT INFORMATION
Name:
Phone:

Name:
Phone:

Should any emergencies occur while my animal is boarding at this facility,
I give permission to treat my pet at my expense: Yes No

Diet:
Will it be supplied? Yes No (If no, we provide Purina EN)

Treats ok? Yes No (If yes, we provide Purina Lite Biscuits)

We offer a choice of a free Hydro-Surge bath the day before pick up. This is a drip dry bath, however the Hydro-Surge will dry fur approximately 95%.
Yes for bath No Thanks

Good with animals? Yes No

Is your dog toy or food aggressive? Yes No

Please list any medical procedures/surgeries you wish to have done during stay:

Please list any medical conditions that we need to be aware of or if your pet has any special needs:

I have read and accept the above:
Owner's Signature
Date