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contact@royersfordvet.com
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Client Name
(Required)
First
Last
Patient Name
(Required)
Date
(Required)
Please provide proof of vaccinations at least 48 hours prior to boarding. All cats must be current on Rabies and Distemper vaccines to board at our facility. If fleas are found on your pet at check-in, treatment will be administered. Guests will receive two meals daily to help us track their food consumption during their stay. If you require a late check-in or check-out, please coordinate with front desk staff in advance. We cannot accept check-ins or check-outs within 30 minutes of closing.
Date of Check In
(Required)
Date of Check Out
(Required)
Owner’s Phone Number During Stay
(Required)
Is anyone else authorized to pick up your pet?
(Required)
Yes
No
If yes, who?
(Required)
Their phone number
(Required)
What type of food do you feed your cat?
(Required)
Wet
Dry
Other
If other, please specify
(Required)
How much food is your cat offered each day? (Example: 1⁄2 cup of dry)
(Required)
Is your pet on any medications?
(Required)
Yes
No
If yes, please list each medication and their dosing instructions
(Required)
Additional Services Requested
Physical Exam (please fill out a drop-off questionnaire)
Nail Trim
Other (ear cleaning, vaccines, etc.)
If other, please specify
(Required)
Does your pet have any special needs for boarding?
(Required)
Items brought with your pet
(Required)
Medicine often involves unpredictable situations that may require emergency treatment, with little time to consult the owner. For this reason, we kindly ask you to specify your preferences regarding CPR and other lifesaving procedures before leaving your animal. Please select one of the options below:
CPR: I authorize the veterinarian to perform CPR and other life-saving measures on my animal while attempting to contact me. I accept responsibility for any related costs, which may exceed the initial estimate.
DNR: I do not wish for CPR or life-saving measures to be performed on my animal if recovery is not possible.
**Please note that if no selection is made, it will be assumed that you selected the option of CPR. **
If my pet requires medical intervention while boarding with Royersford Veterinary Hospital, I:
(Required)
Give RVH permission to treat my pet without contacting me up to $_______
Do NOT give RVH permission to treat my pet without contacting me first.
Give RVH permission to treat my pet without contacting me up to $
Client Signature
(Required)
Date
(Required)
