Canine Boarding Check In Form

Filling out this form does not create a reservation.
Reservations must be made via phone at 970-226-6526.

First Name

Last Name

Pet(s) Name

Phone

Email Address

Check In Date

Check Out Date

Accomodations

Does your dog have a history of jumping a 6’ fence?

Yes

No

Choose your pets accomodations

Town and Country - (Indoor/Outdoor kennels—suitable for small to giant breed dogs) Base boarding plus nightly tuck-ins. $53 per day for each dog. $43 per day per additional dog (same run).

Big City Suites - (Indoor only—suitable for SMALL BREED dogs only; combined weight of 40lb) Base boarding plus treats, potty walks & nightly tuck-ins. $53 per suite. $43 per day per additional dog (same run).

If you choose Big City Suites, please select your pets complimentary treat

Canned Food

Peanut Butter

None

Additional Amenities

Kong filled with peanut butter - $8 per day

Kong filled with canned food - $8 per day

DayCare with Boarding: $10 - additional dog $5

Nail Trim - Basic - $19

Nail Trim - Dremel - $25

No additional amenities

Exit Bath (additional charges apply)

Yes

No

Vaccinations/Exam/Testing

Rabies Distemper/Parvo

Bordetella

Leptospirosis

Influenza Exam

Fecal Test

Heartworm Test

Feeding Instructions

What kind?

CPS Food (Science Diet Sensitive Stomach & Skin)

Own Food (Specify Brand Below)

Own food brand:

When should we feed your dog?

Morning

Noon

Evening

How much should we feed your dog?

Does your dog have food sensitivities or allergies?

Yes

No

Please specify any allergies or sensitivities.

*We may need to use our canned food to encourage your pet to get enough to eat during their stay or if your pet runs out of food while they're with us.

Medication Instructions*

Daily medications charges apply

Medication #1:

Dosage:

When to give medication:

Morning

Noon

Evening

Medication #2:

Dosage:

When to give medication:

Morning

Noon

Evening

*Medications, or special procedures will incur an extra fee. By signing on the
next page, you are giving Come, Play, Stay! permission to administer any off label (not labeled for animal use)
medications or supplements listed above.

Special Procedures or Instructions (If not please write "NONE")

Please list any Allergy, Health, or Medical Concerns (If not please write "NONE")

Please check if your pet has been experiencing any of the following

Vomiting

Sneezing

Diarrhea

Coughing

Not using the litter box

Lumps/Bumps

Abnormal energy level/behaviors

Emergency Number to Reach Owner:

Regular Veterinarian:

Please Read and Accept

I understand that I will be charged for a full day of boarding on the day of drop-off and pick-up, unless I pick my pet up before 11:00 am Monday-Saturday, and I will always be charged for a full day of boarding on Sunday. I agree to pay in full with cash or credit card (we do not accept checks) at the time of pick up.

Please Read and Accept

Reasonable precautions will be taken against communicable disease, illness, injury, escape, or death of this pet. South Mesa Veterinary Hospital/Come-Play-Stay and staff will not be held liable for problems that might develop provided reasonable care and precautions are followed. I agree that any medical problem that develops with my pet will be treated as necessary in accordance with routine procedures and I assume full financial responsibility for all such treatments. A South Mesa Veterinarian will make every attempt to contact me in the event that my pet needs medical attention. As required by the Colorado Department of Agriculture, PACFA Regulations, Description 16.00 G. 3., in the event of death, the facility will provide interim body care (cold storage at South Mesa Veterinary Hospital) until the owner is reached and final plans are made. I assume full financial responsibility for all medical treatment my pet needs, even if I cannot be contacted. South Mesa Veterinary Hospital/Come-Play-Stay is not liable for the loss, damage or destruction of personal belongings.

Release For Pets Under 6 Months of Age

I understand that, due to the young age of my pet, it may be more susceptible to disease as its immune system has not been completely developed.

Digital Signature Agreement. Please enter your name.

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Canine Boarding Check In Form