Pet Health First Aid Dental Care Senior Pets Exotic Pets Puppies & Kittens	Boarding   Pet's Name: Pet's Birth Date: Species: Select Canine Feline Exotic Avian Breed: Sex: Select Male Male(neutered) Female Female(spayed) Color: Weight: Select Less than 80 pounds Greater than 80 pounds Owner's Name: Address: City:    State:  e-mail: Home Phone: Cell Phone: Emergency Contact Name: Emergency Contact Phone: Veterinarian: Veterinarian Phone: Skin Condition: Chronic Health Problems:   Drug Sensitivity: Is your pet on medication?   Yes   No Medication 1: Dosage: 1 2 3 4 5 6 Times Daily Medication 2: Dosage: 1 2 3 4 5 6 Times Daily Medication 3: Dosage: 1 2 3 4 5 6 Times Daily   Special Diet? Yes   No Name of Food: Feed:   1   2   3 Times Daily All boarders are fed Pet Land Diet unless otherwise specified   Accommodations: Rates Select Classic Preferred Five-Star Walking Service:  Rates Select No Thanks 1x Daily 2x Daily Grooming: Rates Select No Thanks Short Haired - Small Dog Short Haired - Medium Dog Short Haired - Large Dog Short Haired - Ex-Large Dog Long Haired - Small Dog Long Haired - Medium Dog Long Haired - Large Dog Long Haired - Ex-Large Dog Nails: Rates  Yes   No   Board From:  Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 2007 2008 2009  To  Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / 2007 2008 2009   Pet Land requires all boarder's vaccinations to be current. Documentation must be provided upon first visit. Bordetella intranasal must be given 3 days prior to boarding. Bordetella injection must be given 14 days prior to boarding. Please discuss the options with your vet.