Montgomery Animal Hospital

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827 Bethlehem Pike, Flourtown, PA 19031

/ (215) 233-3958

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Boarding Consent Form

Step 1 of 3

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Boarding Pick-Up and Drop-Off Times
Boarding Pick-Up Times Boarding Drop-Off Times
Monday-Friday: 8:00 a.m. – 6:00 p.m Monday-Friday: 12 p.m.- 6:00 p.m
Saturday: 8:00 a.m. – 4:00 p.m. Saturday: 10:00 a.m. - 4:00 p.m.
Sunday: 8:00 a.m. -12:00 p.m. Sunday: 10:00 a.m. – 12:00 p.m.
MM slash DD slash YYYY
Time of Pick-up
:
Emergency Contacts (Two people we can contact who WILL NOT be with you while you are away):
*Boarding Rate Are Determined by Animal Species & Weight
*These Rates DO NOT include Medical Care or Clean-Ups Needed While Boarding*
Bathing and Clean-Up Charges(Required)
MM slash DD slash YYYY
PLEASE READ THE FOLLOWING BEFORE AGREEING:
  • If tranquilization / sedation is necessary for treatment or handling of my pet, I give my permission for Montgomery Animal Hospital to administer such medication(s). I understand that there is a charge for such medications.
  • All dogs or cats entering Montgomery Animal Hospital MUST be up to date on vaccinations and free of external parasites (fleas, ticks, etc.) or they will be treated upon entry at the owner's expense.
  • I authorize Montgomery Animal Hospital to treat my dogs or cat should he or she develop a medical problem while boarding, and I agree to pay for all exams and treatment services rendered.
  • I agree to contact Montgomery Animal Hospital if I am unable to pick up my pet as scheduled.
  • I agree to pay in full for all services rendered by Montgomery Animal Hospital and to pay for those services at the time of discharge.
  • PETS ARE RELEASED ONLY DURING REGULAR HOSPITAL HOURS. If I neglect to pick up my pet within 10 days of the scheduled date, Montgomery Animal Hospital may assume that my pet has been abandoned and may arrange for disposal of my pet in any way deemed necessary.
  • Should I abandon my pet, I understand that I am liable for all charges incurred, that I will be reported to the authorities, and that I may be subject to prosecution.
  • I understand that DISCHARGE TIME IS 9 AM, and that an additional day of boarding may be assessed for all dogs or cats picked up after that time.
MM slash DD slash YYYY
Medications
Name
Dosage
Amount/Frequency
 
Belongings
Item
Item Description (color, size)
 
Pet's Name
Feeding Instructions
Our in-house diets are Purina EN prescription dry food and Purina ProPlan canned food. We can feed your pet either of the two or a mixture of dry and canned.
Check ONE of the following boxes and indicate how much and how frequently you feed. (cups, tablespoons, etc.)
food provision
*Note: All food is to be labeled with your pet's First and Last Name with a permanent marker
AM Feeding
# bags of dry
# can(s) of wet
Please fill in the blank: Feed __ bags of dry with __ can(s) of wet
PM Feeding
# bags of dry
# can(s) of wet
Please fill in the blank: Feed __ bags of dry with __ can(s) of wet
Have you noticed any of the following over the past month?
Vomiting
Diarrhea
Coughing
Sneezing
Limping
Loss of Appetite
Increase of Appetite
Other

Get In Touch With Us Today

  • Please use this form for general information purposes only. DO NOT send personal health information through this form. Specific patient care must be addressed during your appointment.
  • This field is for validation purposes and should be left unchanged.

Office Hours

Mon, Tue, Wed, Thu 8 AM – 7 PM
Fri 8 AM – 6 PM
Sat 8 AM – 4 PM
Sun 8 AM – 12 PM

Appointments

We will do our best to accommodate your busy schedule. Request an appointment today!

Request Appointment

Get In Touch

(215) 233-3958

mahflourtown@gmail.com

827 Bethlehem Pike
Flourtown, PA 19031

Montgomery Animal Hospital

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