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Menu
HOME
ABOUT US
Meet Our Veterinarians
Meet Our Staff
SERVICES
Boarding
Canine Health Care
Pet Nutritional Counseling
Pet Behavior Counseling
Feline Health Care
Pet Nutritional Counseling
Pet Behavior Counseling
Senior Pet Care
Pet Drop Off Appointments
Diagnostic Care
Dental Care
Non-Anesthetic Dental Cleaning
Surgical Services
Microchipping
Pharmacy
Pet Bathing
ONLINE PHARMACY
RESOURCES
Get Our App
Pet Health Library
New Client Center
Our Location
Promotions
Online Forms
New Patient Registration Form – Canine
New Patient Registration Form – Feline
Boarding Form
Surgery/Treatment Consent Form
Euthanasia Form
BLOG
CONTACT US
Request A Refill
EMERGENCY
561-582-3364
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1110 2nd Ave N,
Lake Worth, FL 33460
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Boarding Form
Boarding Form
Required fields are marked [*]
Owner's Name
*
First
Last
Email
*
Cell Phone
*
Pet's Name
*
Boarding Date Drop Off
*
MM slash DD slash YYYY
Boarding Date Pick Up
*
MM slash DD slash YYYY
All vaccines, heartworm test and fecal must be current: If your pet is not current on their vaccines, heartworm test, and fecal, they will receive them when they are dropped off for boarding.
*
I accept
All Boarders will be bathed on day of pick up. Discharge will be after 12pm, unless otherwise arranged.
*
I accept
Are you providing us with your pet's food?
*
YES
NO
Diet:
*
How much:
*
How Often?
*
Is your pet taking any medications that need to be given while boarding?
*
Are there any problems that the veterinarian needs to examine while your pet is here?
YES
NO
Please list problems:
*
Did your pet have his/her flea prevention this month?
*
YES
NO (If "no" is selected one will be given to him/her.
Should the pet(s) above become ill or have diarrhea while boarding, I hereby request Lake Worth Animal Hospital to provide all responsible medical / surgical treatment that is necessary.
*
I have read the above and I am in full agreement.
I agree to pay all related charges associated with the boarding and treatment of my pet(s) at time of drop off.
*
I have read the above and I am in full agreement.
I do hereby forever release and discharge Lake Worth Animal Hospital and the attending veterinarian from any and all liability arising from such procedures and treatments and services.
*
I have read the above and I am in full agreement.
Date
MM slash DD slash YYYY
Entering your name here will serve as a digital signature:
*
CAPTCHA
Comments
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