633 N 66th St. Lincoln, NE 68505
(402) 464-1382
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Boarding Form
Thank you for choosing our Boarding Facilities!
Our facilities will allow your pet to be as comfortable as possible while you are away. Please feel free to contact us for a tour of our facilities at any time. Please do not assume your boarding arrangements are confirmed until we have contacted you to confirm the requested dates.
IMPORTANT: Boarding dates and arrangements are not confirmed until you have received notification. A staff member will contact you by phone or email.
Name
*
First
Last
Email
*
Phone
*
Pet Name
*
Has your pet stayed with us before?
*
Yes
No
Please fill out any Comments or Special Instructions below: (feeding, medications, housing, exercise, request for veterinary services while boarding, etc)
I am bringing additional items with my pet
(please describe)
Drop off Date
*
Date Format: MM slash DD slash YYYY
Drop off Time
*
:
HH
MM
AM
PM
Pick-up Date
*
Date Format: MM slash DD slash YYYY
Pick-up Time
:
HH
MM
AM
PM
Additional Services
Check box if approved
Bathing Package ($25): Your pet will get a bath the day you are scheduled to pick them up, as well as a nail trim and ear cleaning. Please plan on picking your pet up after 10AM to give them time to dry after their bath. If you would like an earlier pickup time, let us know and your pet will be bathed the night prior.
Boarding KONG Treat ($5/Stay): Your pet gets a chilled Kong chew toy, with fresh treats and tasty peanut butter applied every day. Please let us know if your pet has food sensitivities and we will give alternate treats.
In the event that your pet becomes ill or needs medical attention while staying with us, we would like to know your preference for care.
*
Please select ONE of the following options and initial beside it:
Provide medical care as deemed necessary for the best care for my pet – you need not call. This includes all diagnostics and medical treatments
Provide medical care, diagnostics, and treatment as deemed necessary for my pet, but please notify me by ( phone / email )
Keep my pet stable and comfortable until you can reach me and I can make decisions regarding treatment. I understand that emergency and supportive care will be given but no additional procedures will be done until I (or my emergency contact) am contacted and give permission.
Do not perform any treatment or diagnostics until I (or my emergency contact) am notified and consent is given. I am aware that any delay in treatment may result in the death of my pet(s)
Emergency Contact #1
*
First
Last
Phone
*
Emergency Contact #2
First
Last
Name
First
Last
Emergency Contact #3
First
Last
Phone
Boarding Authorizations
*
I understand that Capitol Animal Clinic is not responsible for loss or damage to personal items left with my pet(s)
*
I agree to pay all charges on the day of pick-up of my pet(s) and I understand that my pet(s) may not leave the premises until all charges are paid in full. I will notify you if my pick-up date changes and I understand that any animal left for ten (10) days beyond the agreed date of pick-up with no contact from the owner is considered abandoned. Without contact, Capitol Animal Clinic will assume custody of the animal and handle said animal at its discretion.
Date
*
MM
DD
YYYY
Home
New Clients
Boarding Form
New Client Registration Form
About Us
Team
Services
Cold Laser Therapy
Wellness Plans
Microchipping
Digital Radiography
Nutrition & Weight Management
In-House Laboratory
Behavior Counselling
Ultrasound
Laser Surgery
Dental Services
Preventative Care
Boarding
Pet Health
Pet Health Library
How-To Videos
Pet Health Checker
Pet Food Recalls
Pet Insurance
Product Recalls
News
Blog
Contact Us
Make An Appointment
Home Delivery