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Boarding Admission Form

Medications (Please List):

Dose or Strength: (Ex: 16mg 100mg)

Frequency: (Ex: 2x a day, every 12 hours)

Dose or Strength:

Frequency:

Dose or Strength:

Frequency:

Dose or Strength:

Frequency:

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.

Full Name:

Today's Date:

Name:

Phone Number: