BY APPOINTMENT ONLY
Mon-
Thur:
8:00 AM – 5:30 PM
Fri:
8:00 AM – 4:00 PM
Sat & Sun:
Closed
425-485-6575
6630 NE 181st St.
Kenmore, WA 98028
Payment Options
Online Forms
Review Us
About
About Us
Our Team
Testimonials
Join Our Team
Specials
Services
Wellness Care
Surgery
Dentistry
Senior Care
Digital Radiology
Nutrition
Resources
New Clients
Online Forms
Payment Options
Outside Resources
Blog
Contact
Book Appointment
Book Appointment
Online Pharmacy
OUR
APP
Boarding Form
Client Information
Owner's Name
*
Boarding Dates
*
Phone number(s) where you can be reached.
*
Emergency Phone Number (friend or relative)
*
Pet Information
Pet(s) Name(s)
*
Does your pet(s) need any vaccinations?
*
Yes
No
Current Dog Vaccinations (check all that apply)
Rabies Vaccine
DHPP Vaccine (Distemper)
Bordetella Vaccine (req. every 6 months)
Canine Influenza H3N2 & H3N8 Vaccine
Leptospirosis Vaccine
Current Cat Vaccinations (check all that apply)
Rabies Vaccine
FVRCP Vaccine
Feline Leukemia Vaccine
NOTE: ALL boarders MUST be current on their vaccinations. If vaccinations were given elsewhere, where and when were they given?
How is your pet(s) health?
*
What is your pet(s) normal diet?
*
Is your pet on any medications? If so, which medications and how often are they given? When were they last given?
*
Please list any carriers, leashes, toys, medications, etc. being left with your pet.
Hospital Services
Would you like us to provide any of the following services while your pet(s) is here?
Exam
Nail Trim
Bath
Anal Glands
Blood Work
Ear Flush
Teeth Cleaning
Microchip
Medication Refill
Other
NOTE: If you are requesting a bath it will be done on the discharge date. Please call ahead to make sure your pet is dry. You will not be charged an additional day of boarding.
Hospital Release
Authorization
*
I hereby authorize Kenmore Veterinary Hospital to provide any medical/surgical procedure for my pet(s) IF NECESSARY during boarding.
Pick Up
*
I understand check out time for my pet(s) is 9 a.m. on the discharge date; if I am unable to pick my pet(s) up by 9 am, I will be charged for an additional day of boarding.
Owner/Responsible Party
*
Date
*
Comments
This field is for validation purposes and should be left unchanged.