Boarding Release Form

Save time during your next appointment! Complete your boarding release
forms online from any device at any time before your visit.

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Boarding Release Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Client Information

Client Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pet Information

Patient Name *

Species/Breed *

Sex *

Male
Female

Birthdate *

Weight *

Arrival Date *

Depart Date *

Special Diet

Dental Work

Surgery

Vaccinations

Instructions or Additional Information

All pets left for boarding must be current on all required vaccinations and free of fleas and ticks.

Date your pet received his/her last flea treatment (Month/Year) *

I authorize the Animal Hospital of Tiffin to administer a dose of flea prevention at my expense since my pet is due for his/her next dose.

I Authorize

Please advise us if someone other than yourself will be picking up your pet for we will not release your pet without your permission. We need a Name and Phone Number of the person who will be picking up your pet. They have to provide us with a photo ID.

Name of Person Picking Up *

First

Last

Phone Number *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

Signature *

Clear Signature

Today's Date *

Email

Boarding Release Form

Boarding Release Form

Client Information

Pet Information

All pets left for boarding must be current on all required vaccinations and free of fleas and ticks.

Please advise us if someone other than yourself will be picking up your pet for we will not release your pet without your permission. We need a Name and Phone Number of the person who will be picking up your pet. They have to provide us with a photo ID.

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