Client Name Patient Name Check-in Date MM slash DD slash YYYY Check-out Date MM slash DD slash YYYY Please list your primary emergency contact for this visitName Number Please list your secondary emergency contact for this visitName Number Please list all articles you plan to leave during your cat’s stay with us. Please understand that we do our best to keep these articles with each cat but occasionally items may be misplaced:What brand of cat food does your cat normally eat at home (a technician will go over amount and frequency of feedings at check-in)? Is your cat on any medication? Yes No MedicationDoseFrequencyLast Given Is your cat on flea prevention? Yes No When was the last dose given? Does your cat need any additional services while boarding? Yes No Please describe:Please review our boarding policies listed below and answer the question that follows:Boarding Requirements: Vaccines: We require that all cats boarding at Morrisville Cat Hospital be up-to-date on their Rabies and FVRCP (distemper) vaccinations. These vaccinations must be given 7 days prior to cat’s boarding check-in date if vaccines are more than 60 days overdue. Flea/Tick/Parasite: We require that all cats boarding at Morrisville Cat Hospital be free from fleas, ticks, and internal parasites. If they are observed at check-in or during your cat’s stay with us, we will treat your cat with Capstar ($6). Common Stress-Related Conditions Policy: Being away from home can be stressful to many cats. Diarrhea, vomiting, constipation, anxiety and inappetence are all common stress-related conditions that will often present when cats are boarding. We monitor our patients very closely each day and will provide appropriate care if any of these conditions develop during their stay with us. Treatment costs may include the cost of possible medications and $8.50 per day to administer medication (if your cat is not already on medications). Inappetence is the most common stress-related presentation. We will medicate your cat with a single dose of an appetite stimulant (Cyproheptadine), at no additional cost, to jump start his/her appetite. If your cat is still not eating after 36 hours with an appetite stimulant, we will try to contact you at your emergency contact. If we are unable to reach you, we will need to syringe feed your cat to prevent dehydration and liver disease from developing. Additional costs will apply for syringe feeding. Illness PolicyWe will treat your cat for common stress-related boarding issues to avoid escalation to more serious illness. If these issues do not resolve within 2-3 days or your cat experiences other illness while boarding, we will immediately attempt to reach you at the emergency number(s) you listed. If we are unable to speak with your contact, we will leave a message. However, if we are unable to reach you, the veterinarian will perform whatever treatments deemed necessary, not to exceed $100, $200, $500, or Any Amount (please select one): $100 $200 $500 Any amount CommentsThis field is for validation purposes and should be left unchanged.