Boarding Admission Form Skip to Main Content Skip to Footer

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Boarding & Daycare
Hours & Location
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Contact

Download Our App
(972) 262-2684

Services
Boarding & Daycare
Hours & Location
About
Contact

Boarding Admission Form

Pet's Name*

Is your pet current on all vaccines required by Animal Clinic of Grand Prairie?*

Yes

No

Has your pet been checked for intestinal parasites in the year?*

Yes

No

Any illness or injury we should be aware of?*

Yes

No

If you answered yes to the previous question, please explain:

Please provide feeding instructions for your pet:*

Medications (Please List):

Name of Medication: (Ex: Apoquel, Gabapentin)

Dose or Strength: (Ex: 16mg 100mg)
Frequency: (Ex: 2x a day, every 12 hours)

Name of Medication:

Dose or Strength:
Frequency:

Name of Medication:

Dose or Strength:
Frequency:

Name of Medication:

Dose or Strength:
Frequency:

Has your pet been given their medication today?

Yes

No

Please list any belongings you brought with your pet today:*

Pick Up Date:*

Will you be picking up your pet in the AM or PM?*

AM

PM

If evidence of fleas is present, flea treatment must be administered. There is a fee charged for this service. Please initial below indicating that you agree to this policy.*

If you'd like to leave additional notes, please do so here:

OWNER RELEASE

I understand Animal Clinic of Grand Prairie cannot guarantee the health of my pet. I understand and will not hold the clinic responsible for conditions that are unavoidable in boarding kennels, such as but not limited to weight loss, hair loss, upper respiratory infections, diarrhea, and fleas. I understand all pets admitted to the clinic must be protected against communicable contagious diseases and must be free of internal and external parasites or will be treated on entry or discovery at the owner/agent’s expense.

Please note that all animals in boarding are left unsupervised after business hours (Mon-Fri 8a-6p, Sat 8a-1p) and are only monitored during kennel shifts by workers on Saturday evenings, and on Sunday mornings and evenings. There is no fire suppression in the building and no overnight staff in the building except during these listed times. By signing this form, you are acknowledging that you have been informed of this and are aware of the inherent risk involved in boarding your pet in a facility that has no overnight staff or fire suppression measures, such as an overhead sprinkler system, in place. We do, of course, have fire extinguishers, and smoke detectors, and all staff are trained in fire safety.

If any problem is observed or develops:

Please treat my pet as required, you need not call me.

Perform only emergency and supportive care. Notify me for permission to begin any other treatment.

Do not perform any diagnostics and/or treatment until I am notified and consent for you to evaluate and treat as recommended.

Should a LIFE-THREATENING EMERGENCY arise, I authorize the medical staff to sedate my pet and/or perform such emergency procedures as may be necessary for the health of my pet until I can be notified. I agree to pay, in full, all charges for necessary services rendered for and to my pet. Costs for emergency exam, triage, and treatment varies upon the nature of the emergency. However, the basic diagnostic exam and cost of stabilization typically cost at least $300 for the exam, intravenous catheter, fluid therapy, diagnostic imaging, and/or lab work. Price increases depending on the severity of the emergency, but any emergency will be communicated as soon as the veterinarian has determined your pet is stable enough to contact you and collaborate with you to determine the best course of treatment.

I understand that the clinic is not responsible for loss or damage to personal items left with the pet including but not limited to leashes, collars, toys, and bedding.

I understand there is an additional charge for any pet deemed aggressive during the boarding period. This includes additional fees for examinations and medications as needed for sedation, and pets who are deemed too aggressive to handle for the safety of themselves, staff, and other patients in the facility may be asked to not board in the future.

Please type your full name below as signature of acknowledgment of the above statement.*

Full Name:
Today's Date:

Please provide the Name and Phone Number of a Responsible Party to be reached in case of an emergency: *

Name:
Phone Number:

Animal Clinic of Grand Prairie

612 North Belt Line Road
Grand Prairie, TX 75050

phone: (972) 262-2684
fax: (972) 264-5190 • email us

Serving the Grand Prairie, TX area, including (but not limited to): Irving, Dallas, Arlington, and Euless.

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