Huebner Oaks Veterinary Hospital: Pre-Boarding Check-In Form

1
Pet Name(s)* This field is required.
Fluffy
2
Pet Parent Name* This field is required.
John Doe
3
Phone Number* This field is required.
Area Code
Phone Number
4
Email* This field is required.
example@example.com
5
Emergency Contact Name and Phone Number* This field is required.
6
Arrival Date & Time* This field is required.Mon - Fri: 7:00am – 6:00pm (closed from 1pm - 2pm) Sat: 8:00am – 12:00pm Sun: Closed
Date
Month
Day
Year
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
7
Departure Date & Time* This field is required.Mon - Fri: 7:00am – 6:00pm (closed from 1pm - 2pm) Sat: 8:00am – 12:00pm Sun: Closed
Date
Month
Day
Year
1
2
3
4
5
6
7
8
9
10
11
12
Hour
00
10
20
30
40
50
Minutes
PM
AM
PM
8
Image Field
9
We are excited to offer boarding options to ensure your pet has the most comfortable stay possible!
10
Nightly Boarding Services
Standard ($38.50 - $44)
11
Treat your pet to a Holiday Dinner during their stay!
12
Would you like to add a Holiday Dinner to your pet's stay?Holiday Dinners are $15.
YESNO
13
We are proud to offer spa and pampering options to ensure your pet has the most relaxing stay possible!
14
Spa OptionsCheck all the apply. All spa services are completed on the last day of stay. Please be sure to let us know pick-up time for services. Price determined by weight. Based on availability. Please call to schedule.
Basic Groom: (Bath, Ear Cleaning, Nail Trim, Anal Gland Expression)
Partial Groom: (Bath, Ear Cleaning, Nail Trim, Anal Gland Expression, light scissoring)
Full-Service Groom: (Bath, Ear Cleaning, Nail Trim, Anal Gland Expression, and requested full haircut)
Nail file to smooth edges
Special Shampoo (anti-itch oatmeal shampoo, whitening shampoo, or flea & tick medicated bath)
Deep Conditioning Treatment
De-Shedding Treatment
De-Matting
15
Would you like to add on Individual Playtime to your pet's stay?Half Day: $10/day Full Day: $20/day
YESNO
16
Would you like your pet to participate in Doggy Daycare?$20/day - must have an assesment and paperwork completed.
YESNO
17
Treat your pet to something special!
Daily
Every Other Day
One Time (add additional instructions on the next page)
Peanut Butter Kong ($5/each)
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Lickimat ($5/each)
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Peanut Butter Kong ($5/each)
Lickimat ($5/each)
Daily
Row 0, Column 0
Every Other Day
Row 0, Column 1
One Time (add additional instructions on the next page)
Row 0, Column 2
Daily
Row 1, Column 0
Every Other Day
Row 1, Column 1
One Time (add additional instructions on the next page)
Row 1, Column 2
1 of 2
18
When would you like your one-time services performed?ex. Kong - Saturday before pick-up
Huge
Large
Normal
Small
Ok
Ok
19
Image Field
20
Completing annual exams, updating vaccinations and performing other preventative care is highly recommended during boarding stays due to our ability to observe your pet for an extended period of time and the added convenience to you. Would you like your pet to receive any of the following services during their stay:
21
Would you like to add any Recommended Preventive Care?*If Heartworm or Flea Prevention is selected, our staff will contact you to discuss the best options for your pet.
Comprehensive Exam with Complimentary Dental Exam
Canine Flu Vaccine
Canine Lepto Vaccine
Heartworm Test
Heartworm & Flea Prevention
Fecal Screen for Parasites
Blood Work to Assess Kidney & Liver Function
Feline FIV/Leukemia Test
22
How does your pet behave around other pets?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
23
Does your pet have any anxieties or fears like storm anxiety or fear of men or women?* This field is required.
24
Has your pet ever displayed food aggression or toy aggression? Elaborate if needed.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
25
In case of an emergency, are we allowed to perform CPR on your pet?* This field is required.
YESNO
26
In case of minor stress related symptoms, such as upset stomach, vomiting, loss of appetite, and/or minor scratches, I give Huebner Oaks permission to examine my pet and provide the appropriate veterinary care.* This field is required.
YESNO
27
Does your pet walk well on a leash?* This field is required.
YESNO
28
Are there any medical or behavioral concerns you would like us to be aware of that will help make your pets stay more pleasant? Or are there any medical behavioral concerns that we need to keep an eye on?* This field is required.
Huge
Large
Normal
Small
Ok
Ok
29
Does your pet require special care?* This field is required.
30
Please indicate any concerns you may have about your pet that our doctor should be aware of during the Comprehensive Exam:
Huge
Large
Normal
Small
Ok
Ok
31
Would you like to add any Specialty Tests?
Ear Infection Check
UTI Check
Lumps & Bumps Check
32
We are almost done! To confirm your pet receives the right care, please fill out the information on the next page.
33
Image Field
34
Will you be providing your own food?* This field is required.
YESNO
35
Feeding Instructions Please include amount and frequency.
Huge
Large
Normal
Small
Ok
Ok
36
Image Field
37
Will your pet require medication during their stay? * This field is required.
YESNO
38
Medication Instructions* This field is required.Please include type, dosage and frequency.
Huge
Large
Normal
Small
Ok
Ok
39
Does your pet have any allergies?* This field is required.Food, seasonal, or other.
YESNO
40
Allergies* This field is required.Please list any allergies and steps to be taken in the event of an emergency.
Huge
Large
Normal
Small
Ok
Ok
41
Vaccination Records Please upload your current vaccination records if they are not already on file.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
42
Anything else you would like us to know?
Huge
Large
Normal
Small
Ok
Ok
43
Texas Law HB2063 Acknowledgement* This field is required.The new Texas Law known as HB2063 will go into effect on September 1, 2023. Under this new law, kennels are required to provide pet owners with written notice in situations where their beloved animals will be left unattended during certain hours or if the establishment lacks an automatic sprinkler system. Starting September 1, 2023, all customers will be asked to sign an acknowledgement of this at every overnight boarding visit. We understand that this may be seen as an additional step in the boarding process, but our goal is to create a seamless and transparent experience for both you and your beloved pets. Thank you for your understanding and continued support as we strive to maintain the highest standards of care.
Clear
44
Pet Parent Signature* This field is required.To confirm that all submitted information is correct, please sign below.
Clear
Should be Empty: