Owner Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Phone *

How did you hear about us? *

Pet Information

Pet Name *

Age *

Breed *

Color *

Gender / Altered?

Male
Female
Neutered Male
Spayed Female

Please tell us the sex of your pet (if known), and if spayed or neutered.

Preventatives

Please list monthly flea, tick, and heartworm preventative products that you administer to your pet, if applicable.

Date Preventatives Last Given

Please list monthly flea, tick, and heartworm preventative products that you administer to your pet, if applicable.

Has your pet stayed with us before? *

Yes
No

Preferred Drop-Off Date (Closed Sundays) *

Please list the preferred date you are requesting to drop off. Specific dates are not guaranteed to be available until confirmed by a staff member.

Drop off Time *

Pick-up Date (Closed Sundays) *

Pick-up Time

How is your pet feeling? *

Describe any health issues your pet is experiencing today.

Feeding Instructions *

How much does your pet eat per meal? How many times does your pet get fed each day?

Medication and/or Supplements (medication dispensing is at an additional fee) *

Please list any medications your pet is taking. How much do they take? How many times per day? Will we give with food/meal or without?

Other Medical Needs

Please list any additional medical needs (i.e. must be carried on stairs).

Behavioral Needs

Please describe any behavioral issues such as aggression or anxiousness toward people or other animals, food or toy aggression, etc. Please also describe details of any altercations your pet has had with people or animals.

Other Behavioral Notes

My pet is potty trained
My pet is comfortable sleeping in a cage/enclosure
My dog should be walked without other dogs present
My pet has received obedience training
Not applicable choices for my pet

Select all answers that apply

Dog Daycare

Yes, my dog would love to play!
No, my dog is not going to play.

If your boarder is a dog, please select if you would like them to participate in daycare at The Radnor Dog Club during their stay (updated vaccinations required). Please note: if your dog has not yet participated in a temprament test, that must be completed before they can join in playtimes.

Other Services

Would you like a bath, nail trim, ear cleaning, or other veterinary services during boarding? If so, please list.

Vaccination History

Click or drag a file to this area to upload.

If you have updated vaccination records for your pet, please upload them here.

Emergency Contact Name *

First

Last

Emergency Contact Phone *

Additional Emergency Contact Name

First

Last

Additional Emergency Contact Phone

Consent
The information contained in this registration is correct to the best of my knowledge. If my animal requires emergency medical attention for any reason while staying at The Radnor Dog Club boarding/daycare facility, I understand that The Radnor Dog Club and/or Radnor Veterinary Hospital will make every effort to contact me at the emergency phone number I have listed, and will inform me of the reason for examination. If I cannot be reached, this signature signifies my agreement an examination by a doctor on Radnor Veterinary Hospital’s staff. I understand that I will be responsible for paying all costs associated with any medical exam, medicines, or treatments that may be required to provide emergency care for my pet. I understand that if my pet displays aggressive or inappropriate behavior that could be dangerous to other animals or staff, my pet may be moved to a more secure location, or removed from dog park activities, if applicable. I also understand that if my dog shows any signs of illness, such as a cough or parasite infection, (fleas) he/she will be removed from common areas or the dog park play area (if applicable) and kept in a cage/run until myself or my second contact can be informed of the issue. I understand that payment is expected at the time services are performed and I am responsible for keeping my payments current. Any past due balances may be subject to collections action. I understand that Radnor Dog Club’s hours will not be extended for pickup time. If the building is closing, Radnor Dog Club will make every effort to contact me before closing. I understand that if I cannot pick up my pet by closing, I will be charged appropriately for my pet’s overnight stay.

I have read and agree to the requirements detailed above for all of my pets boarding at Radnor Veterinary Hospital

Boarding Information Form