Pre-Boarding Express Registration Form - Valley Veterinary Hospital | Serving the Amherst, Hadley, Northampton area

Valley Veterinary Hospital and Inn for Pets

RETURNING GUEST

PRE-BOARDING EXPRESS REGISTRATION FORM

This form is to be used for confirmed reservations of RETURNING guests only. Please call 584-5252 or submit a reservation request online if you do not already have a boarding reservation.

Please fill out and submit this express registration form to our office AT LEAST 48 HOURS PRIOR TO YOUR ARRIVAL to allow us to provide the best care for your pet and to expedite your check-in process.

Owner's Name:

First Last

Pet Name # 1:		Pet Name # 2:
Pet Name # 3:		Pet Name # 4:

Reserved Check in Date:

Reserved Check out Date:

Approx. Time:

Preferred Service Plan:

VIP

Basic

(see web site for descriptions)

Additional Playtimes? ($4 /session) Yes No

Emergency Contacts:
No change in emergency contacts, use numbers on record.
I will review and change emergency numbers at check-in.

Feeding Instructions:
No change in feeding instructions.
I will review and change feeding instructions at check-in.

Additional Services: I would like the following services performed during my pet�s stay at the INN (additional fees):

Dogs Only: I would like my pet to have a pre-departure bath (no charge for VIP stays of 5 days or more)

Nail Trim

Ear cleaning
Frontline flea and tick repellant

Medication administration - Please provide clearly identified and labeled medications with the size of the pill, total dose, and frequency of administration. There is a medication fee of $3 per pet per day.

Medication # 1:
Medication # 2:
Medication # 3:

Personal items that will be left with pets (limit 2 toys per pet, no bedding, no rawhides):

Veterinary Services Needed?

Yes (please describe)

Special instructions regarding this stay:

If your pet is NOT a regular patient of Valley Veterinary Hospital please provide the following:

Name and location of regular veterinarian:

Any new or chronic medical problems that we should be aware of?

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