Boarding Admission Form - The Cat Hospital of Media

Are you a current client of The Cat Hospital of Media?*

Yes
No

Note: All new customers will be required to complete a New Client Application after submitting this Boarding Form.

Owner's Name*

Pet's Name*

Drop Off Date*

Pick Up Date*

Type of boarding unit

Kitty Condo ($42/night)
Euro Condo ($42/night)
Suite ($52/night)

To view individual units, click here.

Phone Where You Can Be Reached*

Email*

Current Diet

Will you bring your own food or use our house food?*

I will bring my own food
I'd like to use your house food

What is the name brand of the food?

AM Food Type*

Dry Food
Wet Food

AM Food Quantity*

PM Food Type*

Dry Food
Wet Food

PM Food Quantity*

Medications

Will we be administering medication during their stay?*

Yes
No

AM Medications and Dosage*

PM Medications and Dosage*

Please write any other instructions regarding diet or medication administration*

All cats boarding at The Cat Hospital of Media must have current proof of an exam within the past year, and a current FVRCP and rabies vaccine. If you do not have a current vaccines and/or an exam this will be done while your cat is staying with us at the owner's expense. Cats boarding with us will be checked for external parasites upon admission and discharge. If signs of fleas, external parasites or internal parasites are found, your cat will be treated. It is strongly recommended that your cat have flea protection while boarding, as we can not guarantee that your cat won't be exposed to fleas during the normal course of business.

Initials

While boarding, I request for my cat:

Exam - $80
Fecal - $47.70
Rabies Vaccine - $40
Flea Treatment (Revolution PLUS) - $33
FVRCP Vaccine - $35
Nail Trim - $24

**Please Note: Exam required with all vaccines.

Other

I understand that the health of my pet cannot be guaranteed. I will not hold The Cat Hospital of Media liable for conditions that are unavoidable in boarding facilities. This includes but is not limited to weight loss, fleas, hair loss, diarrhea and upper respiratory infections. I understand that all cats admitted to The Cat Hospital of Media must be protected against communicable contagious diseases and must be free of internal and external parasites, or they will be treated upon admission at the owner's expense. I understand that if my cat eats a special diet, I must provide the diet or purchase the diet here if available. All boarding cats are fed a dry commercial diet. If this is not what your cat normally eats, a change in diet may cause upset stomachs and/or diarrhea.

If I cannot be reached, I authorize emergency treatment up to $*

Emergency Contact Name*

Emergency Contact Phone*

Signature of Owner*

Name

This field is for validation purposes and should be left unchanged.

Summer Hours