Hospital Boarding Form

    Help us prepare for your special-needs pet’s stay with us by completing your required hospital boarding form online before your visit.

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    Hospital Boarding Form

    Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

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    Diabetic Pets

    All diabetic pets will have a blood glucose test done upon check-in and check-out.

    Per Dose
    Per Dose
    Per Dose

    Medications to give: (Additional fees apply)

    Canine (*Rabies, *DaP or *DHPP, *Leptospirosis, Bordetella, H3N8 CIV, H3N2 CIV, and Fecal test) Feline (*Rabies, *HCP or *FVRCP)
    Canine (*Lyme vaccine and Heartworm test) Feline (Fecal test and *Feleuk vaccine)

    I am the owner of the animal described below and authorize Old Dominion Animal Health Center (ODAHC) to provide services as necessary to preserve the pet’s life and well-being, and I absolve and release Old Dominion Animal Health Center from any loss, expense, or liability arising from the performance of these services.

    I also understand that the animal must be current on all vaccinations and parasite checks. I authorize the animal to be vaccinated, and/or bathed if necessary, and that these services will be charged at the regular hospital fees. I understand that the center is closed and not medically staffed outside of regular business hours, except by appointment or in an emergency; however, an experienced staff member lives on the premises and staff is present for cleaning, feeding, and exercising 24 hours a day.

    I accept all financial responsibility for the above services and understand that, unless agreed to in advance, these fees must be paid before my pet is released. Effective 12/01/2023: all prices listed, advertised and quoted include a 3% Cash Discount incentive built into the pricing. This discount is for cash, debit and check purchases. Any purchase made with a credit card will NOT receive the Cash Discount. A noncash discount adjustment will be displayed on your credit card receipt.

    Authorization:

    *I also accept that any medical condition we believe to be putting this pet in pain or Risk, including intestinal upset, will be treated immediately at regular hospital Fees.
    *Boarding charges accrue by calendar day.
    *Old Dominion Animal Health Center is not responsible for the loss or destruction of any items left with the pet.

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    Drop off Date

    If my pet becomes critically ill and I am unavailable, I have an Advance Medical Authorization form.

    (This form is required for each visit for a hospital stay. Please complete the Advance Medical Authorization form.)