Boarding Check-In List - Salmon Brook Veterinary Hospital

Please Call (860) 653-7238

136 Salmon Brook Street,
Granby, CT 06035

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Boarding Check-In List

All required fields are marked (*)

"*" indicates required fields

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*

MM slash DD slash YYYY

Pick-Up Date

MM slash DD slash YYYY

I have scheduled grooming to be done on this Date

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

Signature

CAPTCHA

Phone

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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feline practitioners

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