Client Name Phone Patient(s) Name Dates requested Dates are not guaranteed until deposit is made, please call the clinic to confirm and make deposit 703-922-8228 We welcome your cat (s) to Kingstowne Cat Clinic. You are welcome to tour our facility before you leave your pet, providing there are no emergencies or surgical procedures taking place. There are a few conditions that you must be aware of prior to boarding your cat in this facility: All cats must have had an examination by our doctors within the year prior to boarding. All cats must have proof of history of vaccination, i.e. FVRCP (distemper) and Rabies vaccine, previously administered by a licensed veterinarian. Vaccines may be given at the time of boarding if needed. Kingstowne Cat Clinic veterinarians may approve exceptions. Any cat may be refused boarding privileges if a contagious disease is suspected. All cats will be inspected for fleas upon admission. The degree of infestation will be recorded in the patient’s record. The cost of flea treatment will be due at the time of pick up from boarding. The type of treatment will be dependent on the degree of infestation, age, and health status of the cat. We may treat with Capstar (oral) and/or Frontline (topical), or Revolution (topical). No guarantee is made that cats presented with fleas will be discharged flea free. A topical flea treatment can be given the day of pick-up at the owner’s request. You are asked to provide any special medications that are not normally stocked in the clinic. There is an extra charge for medications given while boarding. Many cats do not eat well while boarding, we might have to feed them different foods to encourage them to eat. Your cat might also be given an appetite stimulant while boarding. State Law requires that we inform you that this facility does not provide 24-hour continuous care. I hereby authorize Kingstowne Cat Clinic to use all reasonable precautions against injury, illness, or death of my cat. Medical or emergency care will be instituted at the discretion of the veterinarian for the well-being of your cat while boarding I will assume full responsibility for the treatment expense involved. Initial Do you give permission for us to post your pets pictures on our social media? YesNo I have read and understood the above conditions and authorize this clinic to board my cat (s). Name) / (Electronic) Signature Date Emergency contact number Questions for Boarding your cat … Please list anything you plan to bring for your pets stay. Examples…bedding, food, medication (list names, doses, times given), toys, etc. Please note- each cat is provided a towel and litter box during their stay. If you bring anything we will do our best to take care of your cat’s belongings but please understand we are not responsible in the event that something gets misplaced or destroyed. Please list if your cat will need any services while staying with us. Examples… Exam (any history or concerns you have), vaccines, nail trim, etc. Please note any information or concerns you have about your cat that you would like us to know. Examples… My cat only eats at night, likes this toy, doesn’t like to be scratched behind her ears, LOVES attention, etc.