Dr. Gary Maves, Dr. Mary Felt, Dr. Angela Clark, Dr. Nicole DiGiacomo, Dr. Allison Roberts, Dr. Christopher Obradovich
Owner’s Name: ___________________________ Pet’s Name: ____________________________ Date of Drop off: _____/______/________ Date of Pickup: _____/______/________
Feeding Directions: Brand of Food
Vaccine Policy: To insure the protection of all pets under our care, written proof of the following vaccinations must be presented at time of boarding. If proof of vaccines is not available, the following procedures will be given at owner’s expense, including a wellness examination fee of $51.00. Please Initial.
CANINE: *Rabies (DuPage Co $34.70)_______ *Note: Rabies price is for 1-Year vaccine (Neutered/Spayed price) DHLPP ($29.75) ____ DHPP ($17.25) ____ Lepto ($15.65)____ Bordetella ($31.50)____ Fecal ($24.00) ___ FELINE: *Rabies (DuPage Co $37.15)_____ *Note: Rabies price is for 1-Year vaccine (Neutered/Spayed price) FVRCP ($16.50) ___ Fecal ($24.00) ___
Other optional services that we offer:
Dog Nail Trim ($16.75) ___ Cat Nail Trim ($13.50) ___ Anal Gland Expression ($31.25) ___
Heartworm Test ($39.00) ___ Feline Wellness Blood Panel ($66.85) ___
Canine Wellness Blood Panel w/ Heartworm Test ($89.50) ___
Special Care: We give conscientious, affectionate, and individualized care to pets left in our trust. If your pet has special needs please advise us. Please also list out any particular behaviors that we should be aware of (example: dislike of other animals, will chase birds, afraid of storms, etc.) All boarders receive a free minor exam by the veterinarian. Brief history of any problems: __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________
Please list any medications your pet may be on along with current directions & time last dose was administered. Note: An additional charge of $5/night will be added for administering medication. Initial _________ Medication: Directions: Time Dose Was Given Last:
Boarding away from home can cause some pets to develop an upset stomach which can lead to diarrhea. If your pet develops diarrhea, a medication called Flagyl, an intestinal antibiotic, can relieve the symptoms. We can start this medication (at a doctor’s direction) for an additional cost.
If my pet begins to have diarrhea (please initial):
_____ I authorize DuPage Animal Hospital to administer Flagyl to my pet.
_____ I do not want Flagyl administered to my pet.
Do you currently use a flea preventative on your pet?
If yes – what type do you use? ______________________
When was it applied last? ________________________
We are an intake facility for Villa Park, Elmhurst, and Wood Dale police departments. Because the police are allowed to drop off strays animals 24/7, we are not always here to check them for fleas. In order to provide the best care and protection for your pet, we would like your permission to apply Advantage, a topical flea preventative, at an additional charge, if your dog is not current on a flea preventative.
_____ I authorize Advantage to be applied.
_____ I do not authorize Advantage to be applied.
_____ I authorize a different kind of preventative to be applied: ________________
In the event that my pet becomes ill, I authorize DuPage Animal Hospital to render medical care, which it deems as necessary. I request that every reasonable attempt be made to reach me or my agent at the phone number below, and I assume financial responsibility for all charges incurred.
Please call before picking up your pet to make sure they are ready to go home.
________________________________________________________________ Kennel Initial: _________
Charles R. Savini, D. V.M. Rhiannon A. Kauffeld, D.V.M. Zachary A. King, D.V.M. 8225 Walnut Grove Road Troy, Ohio 45373 Practice Limited to Equine Medicine and Surgery A SAMPLE ROTATIONAL DE-WORMING PROGRAM December 1 It is recommended that either ivermectin (Zimectrin, Equimectrin, Rotectin 1, etc.) or moxidectin (Quest) be used at this time to kill migrating bot lar
N° REG-0011A Reglement Version en vigueur 17.09.2013 Nombre d'annexes Über die Ausgabe von Fahrkarten für Ski- und Snowboardlehrer ALLGEMEINES Art. 1 Die Vereinigung Walliser Bergbahnen (WBB/RMV) erstellt spezielle Abonnemente gemäss dem Freikartenreglement Ziffer 3.5 für Ski- und Snowboardlehrer, beziehungsweise Instrukteure SSSA und Inhaber des eidg. Fachaus