8:30 AM – 5:00 PM
Sat & Sun:
6630 NE 181st St. Suite F103,
Kenmore, WA 98028-4852
Phone number(s) where you can be reached.
Emergency Phone Number (friend or relative)
Does your pet(s) need any vaccinations?
Current Dog Vaccinations (check all that apply)
DHPP Vaccine (Distemper)
Bordetella Vaccine (req. every 6 months)
Canine Influenza H3N2 & H3N8 Vaccine
Current Cat Vaccinations (check all that apply)
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.
Would you like us to provide any of the following services while your pet(s) is here?
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.
I hereby authorize Kenmore Veterinary Hospital to provide any medical/surgical procedure for my pet(s) IF NECESSARY during boarding.
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.
This field is for validation purposes and should be left unchanged.