Boarding Check-In List - Salmon Brook Veterinary Hospital

Please Call (860) 653-7238

136 Salmon Brook Street,
Granby, CT 06035

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Veterinary Care in Connecticut and West Massachusetts

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M-F 7:30am – 8:00pm
S 8:00am – 5:00pm
Sun 2:00pm - 5:00pm
Boarding pick-up / drop-off only

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EQUINE / BOVINE
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FORMS
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PAY BILL

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Boarding Check-In List
Chemotherapy Patient Check-In Sheet
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Forms
Boarding Check-In List
Chemotherapy Patient Check-In Sheet
Contact
Diabetic Pet Drop-Off Form
New Client Form
Prescription Refill

Boarding Check-In List

All required fields are marked (*)

Owner's Name*
First Last
Account Number*
Owner's Email*

For a copy of this submitted form for your records
Pet's Name*
Admit Date*
Date Format: MM slash DD slash YYYY
Pick-Up Date
Date Format: MM slash DD slash YYYY
I have scheduled grooming to be done on this Date
Date Format: MM slash DD slash YYYY

(Grooming is done Monday-Saturday with prior reservation only)
Would you like playtime every day?*
- Yes
- No
( Playtime is not done on the day of admission or discharge)
If you would not like playtime every day, please list the days you would like.
Emergency Contact Name:*
Emergency Contact Phone:*
Vaccinations
Vaccinations must be up to date for admission into the hospital. Please bring vaccination history if they were administered at another hospital. Dogs need Rabies, Distemper, Leptospirosis, Bordetella, Influenza, and a negative fecal within the year. Cats require Rabies, and Distemper vaccinations.
Diet
We normally feed Science Diet to dogs and Purina EN to cats. We carry a full line of Science, Purina, and Hill’s puppy/kitten, maintenance and prescription diets. If you would prefer to use your own diet, in must be in a sealed plastic container.
Choose Food Used:*
- Use my own food
- Use Salmon Brook Vet Hospital Food
Name of food:*
How much/how often for food?*
Medication
*Each medication must be in its original container
Would you like to add any medications?*
- Yes
- No
Name of Medication
Give this many pills or this much liquid-or apply to which eye or ear
Give this often (once, twice, three times daily, etc.)
Would you like to add a Second Medication?
- Yes
- No
Name of Second Medication
Give this many pills or this much liquid-or apply to which eye or ear for Second Medication
Give the Second Medication this often (once, twice, three times daily, etc.)
Would you like to add a Third Medication?
- Yes
- No
Name of Third Medication
Give this many pills or this much liquid-or apply to which eye or ear for Third Medication
Give the Third Medication this often (once, twice, three times daily, etc.)
Anything else we should know about your pet's visit with us?
Pet Owner's Name*
First Last
(This will serve as your digital signature)
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Comments
This field is for validation purposes and should be left unchanged.

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136 Salmon Brook Street, Granby, CT 06035

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