• Charlottesville Boarding Intake Form

    If you have made a boarding reservation with us, save time by using our online form below to give us the information required to drop off your pet, or you may print and fill out the form by clicking on the button below.

    Charlottesville Boarding Intake Form
    Name
    Name
    First
    Last

    What is your pet's discharge date and time?

    RFor weekend pickup:
    Saturday: 7:30 am - 9:00 am
    Sunday: 4:30 pm - 6:00 pm
    If picking up on the weekend, please list a specific time in the allowed window, please park in our gravel lot entrance off Rose Hill Drive and come in our bottom entrance and check-in; if unable to reach us please call 434-979-5055.
    Time
    :

    Feeding Your Pet

    How many cups or cans does your pet eat?
    How many times per day?
    If your pet doesn't eat his/her food while here, what would you like us to?

    Care Instructions

    What belongings are you leaving with your pet today?
    We welcome personal items, which provide your loved one with the comforting scents of home. We ask that all items are labeled and please do not bring any items that have sentimental value. While we do everything in our power to keep these articles safe, clean, and with your pet for their intended use, WE WILL NOT BE HELD RESPONSIBLE FOR ANY ITEM(S) WHICH HAS BEEN LOST OR DESTROYED.
    Are any medicines necessary while boarding?
    $5.00 per day; $15.00 a day for specialty medications (chemo)
    Give names of any medications, dosage, and times to given of each.

    Additional Services

    Would you like a bath?
    $35 up to 20 lbs, $45 31-60, $55 over 61 lbs
    Complimentary bath will be given after 7 days of boarding
    Would you like a nail trim?
    $18.75
    Would you like any vaccinations done during your pet(s) stay?
    Do you need any refills of medication while here?
    Do you need Heartgard refills?
    Do you need Nexgard refills?

    REQUIREMENTS FOR BOARDING

    1. Owner understands and agrees that dog(s) are healthy while boarding at Old Dominion Animal Hospital and are current on vaccinations for rabies, distemper, and Bordetella at least 14 days prior. Owner is not boarding any dog(s) that have any condition that could potentially jeopardize the health of other dogs or people and has not had any potentially communicable condition within 30 days prior to enrollment. Owner further understands that there is a chance that dog(s) could contract Bordetella (Kennel Cough). Owner agrees to not hold Old Dominion Animal Hospital responsible if their dog(s) contracts Kennel Cough or other dog-dog transmitted ailments.

    2. All animals must be free of external parasites (ex. ticks, fleas, etc.), or they will be treated at owner's expense.

    3. Old Dominion Animal Hospital has my permission to do whatever is necessary should an emergency arise.

    4. If a tranquilizer is necessary for treatment or handling, Old Dominion Animal Hospital has my permission to administer such medication.

    5. Check-out time is between 8:00 am - 12:00 pm Monday- Friday. If your pet is picked up after 12 PM Monday - Friday you will be charged an additional day. Weekend check-out/drop off time on Saturday between 7:30 - 9:30 am and on Sunday between 4:30 - 6:30 pm.

    6. If your pet needs to have medication given to them while boarding it is $ 5.00 daily.

    I authorize the staff at this veterinary practice to take photographs and/or videos.
    I agree not to file any claim for revenue or lawsuit for damages against this veterinary practice with respect to the release of this information.
    Photos and videos may be used with the following media entity(ies):
    I have read the boarding requirements and understand the hospital's policies.
    Choosing "yes" acts as your virtual signature.

Personal, Professional, Passionate Care for Your Pets