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(631) 271-8383
M-F: 8:30am-6pm | SAT: 8:30am-2pm
1166 E Jericho Turnpike, Huntington, NY

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Vet Services
Meet Our Team
- Our Veterinarians
- Our Staff
Therapy Options
Current Clients
First-Time Clients

Boarding Form

Boarding Form

Pet Information

Pet's Name *

Last Name *

Last Weight *

Drop Off Date *

Pick-Up Date *

Pet Alerts (Dog Aggressive, Eats Blankets, FIV + etc.)

Emergency Contact Name for Pet *

Phone *

Feeding Instructions

Did you bring your pet’s food with you today? *

Yes

No

How often do you feed your pet? *

How much do you feed your pet? *

When will be the last time your pet has a meal on day of drop off? *

Medication Instructions

Is your pet currently taking any medications or supplements? *

Yes

No

How many medications is your pet taking?

Medication #1

Name

Quantity

Frequency

Last given dose on day of drop off

Notes

Medication #2

Name

Quantity

Frequency

Last given dose on day of drop off

Notes

Medication #3

Name

Quantity

Frequency

Last given dose on day of drop off

Notes

Medication #4

Name

Quantity

Frequency

Last given dose on day of drop off

Notes

Medication #5

Name

Quantity

Frequency

Last given dose on day of drop off

Notes

Medication #6

Name

Quantity

Frequency

Last given dose on day of drop off

Notes

Optional Services (additional fees will apply)

Would you like your pet to receive a bath prior to going home? *

Yes

No

If soiled? *

Yes

No

Would you like your pet to receive a nail trim prior to going home? *

Yes

No

Wellness Services to be updated for boarding (check all that apply).

Exam

Rabies Vaccine

Da2PP Vaccine

Bordetella Vaccine

Lyme Vaccine

Leptospirosis Vaccine

Senior Wellness Labs

Junior Wellness Labs

4dx (Heartworm Test)

FDCVR Vaccine

Leukemia Vaccine

OtherOther

I understand that payment is expected at the time services are rendered. I hereby authorize the staff of Dix Hills Animal Hospital to render any treatment which is deemed necessary to the health of my pet(s) while in custody of the hospital. I understand that in the event of any unusual or emergency circumstances, the staff will make every attempt to contact me or my designated representatives before, if time permits, proceeding with the treatment. I understand that I will be financially responsible for all emergency procedures including the Estimate of Charges provided to me in person or over the telephone. I understand that a deposit is required for all pets admitted to the hospital. I understand that if my account is not kept in good standing, a finance fee of $25 will be added to the account and it will be forwarded to a third-party collections agency, which may affect my credit rating. I understand that photos/videos may be taken of my pet for training or marketing purposes.

Signature of Owner / Agent / Good Samaritan: *

Date *

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(631) 271-8383
Mon - Fri: 8:30am – 6:00pm
Sat: 8:30am – 2:00pm
1166 E Jericho Turnpike
Huntington, NY 11743

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