All pets admitted to Piper Glen Animal Hospital must be current on the following vaccinations: Canine - Rabies, Distemper/Parvo and Bordetella; Feline - Rabies and Distemper. Piper Glen Animal Hospital reserves the right to vaccinate your boarded pet(s) in the absence of proof of up-to-date vaccines.
Your pet(s) must be current on flea protection to stay in our facility. It is strongly recommended for your pet(s) to be current on heartworm and intestinal parasite protection as well. If your pet(s) is not current or shows signs of parasites, we will treat your pet(s) with the most effective single dose of medication at the owner's expense.
Owner's Name:
Address:
Street 1:
Street 2:
City:
State:
Zip:
What pet(s) will be staying with us?
Pet Name:
CanineFeline
What accommodations would you like for your pet?
Pet Name:
CanineFeline
What accommodations would you like for your pet?
Pet Name:
CanineFeline
What accommodations would you like for your pet?
Pet Name:
CanineFeline
What accommodations would you like for your pet?
Would you like your pets to board in the same accommodation? (Where available)
NoYes
Boarding multiple pets together in a single accommodation is done at the owner's request and the owner assumes all risk and responsibility. If you have chosen to board multiple pets together, we reserve the right to observe their behavior and, if necessary, separate them. If there are any injuries sustained from multiple pet accommodations, treatment of the injuries is the financial responsibility of the owner.
Scheduled Arrival Date:
Scheduled Departure Date:
Main Contact Number:
Alternate Contact Number:
Will your pet(s) need to see a doctor while boarding?
NoYes
If Yes, please explain:
For Yearly Comprehensive Wellness Exams, Piper Glen Animal Hospital will update all vaccines and perform all medically required procedures unless indicated otherwise. Please make a note above of any concerns the doctor should address during the exam.
Do you request a specific doctor if he/she is available?
Would you like a phone call after the physical exam?
NoYes
Has your pet previously had adverse reactions to any vaccines or medications?
NoYes
If Yes, please explain:
Is your pet currently taking any medications?
NoYes
If Yes, please provide the medication name, dosage and frequency:
Is your pet currently taking any nutritional supplements?
NoYes
If Yes, please provide supplement name, dosage and frequency:
What do you currently feed your pet?
Do you intend to bring your own food? (We feed Iams Low Residue dry food and Purina EN canned food.)
NoYes
Please describe your feeding instructions (Quantity and Frequency):
What Heartworm Preventative do you use for you pet?
What Flea and Tick Preventative do you use for your pet?
What was the last day you used flea and tick preventative for your pet?
Is your pet predominately:
Indoor
OutdoorBoth
Personal items you intend to bring:
Piper Glen Animal Hospital will exercise care and caution with all belongings for the duration of this stay. Piper Glen Animal Hospital cannot be held responsible for lost or damaged items. We will supply your pet(s) with towels/blankets during his/her stay with us. Please let us know if these items should not be given to your pet.
Canine boarders receive a complimentary bath and dry on the day of departure. You may request the following services at an additional cost:
Salon Bath Upgrade: Complete bath and dry, nails trimmed, anal glands expressed and ears cleaned. Cost: Up to 20lbs. - $12.00; 21 - 40lbs. - $13.00; 41 - 80lbs. - $15.00; 81 - 100lbs. - $17.00; Over 100lbs. $19.00; Felines - $24.00
Shed-It-Out: Full brush-out using the Furminator. Cost: Felines - $15.00 and up; Canine Short Hair - $10.00 and up; Canine Medium Hair - $20.00 and up; Canine Long Hair - $30.00 and up.
Medicated Bath: Use of medicated shampoo to help soothe itchy dry skin or if prescribed by a doctor. Cost: $5.25
Grooming: Full Salon Bath services and a haircut. Please note: Limited availability. A separate grooming appointment must be scheduled. Cost: (See our price list under "Our Services")
Please select any additional services for your pet: (Please hold the CTRL key to select multiple service)
Is there any additional information we might need to know about your pet(s) and their special needs and/or requests?
Piper Glen Animal Hospital will use all reasonable precauton against injury, escape, or death of my pet(s). The clinic and staff will not be held liable for any problems that develop provided reasonable care and precautions are followed. I understand that if a medical problem is discovered, Piper Glen Animal Hospital will telephone the owner or emergency contact to discuss the problem and determine the best course of action to be taken. If the owner cannot be reached, the attending veterinarian has my permission to take the necessary steps to diagnose and treat in accordance with current medical standards. In case of emergency, measures to preserve and stabilize vital functions shall be taken immediately. I hereby acknowledge responsibility for making arrangements for my pet(s) pick up before closing on the day listed above unless other arrangements are made in advance and approved by Piper Glen Animal Hospital. Failure to retrieve my pet(s) within 10 days will cause my pet(s) to be considered abandoned and my pet(s) will become the property of Piper Glen Animal Hospital. I assume full responsibility for lodging, veterinary services and any other expense incurred while my pet(s) is boarded. I verify that I have read and fully understand and agree with the terms of this agreement.
By submitting this form you are digitally signing that you accept the terms of this agreement. You are NOT GUARANTEED a reservation, but will be contacted via email or telephone to confirm your request within 24-48 hours, excluding weekends and holidays.
Please confirm this reservation via:
Email
Telephone
Confirmation email address or telephone number;
Please check if you would like to receive an estimate for requested services via email.
Clinic Info
Monday and Wednesday
7am - 7pm Tuesday, Thursday,Friday
7am - 6pm Saturday
730am - 12pm Sunday
4pm-5pm
For Boarding Pick-up Only
For after hours emergency care call (704) 588-7015
Pet Portal
Contact Information
Phone: 704-541-7171
Fax: 704-541-1377
Email:
Directions » 5105A Piper Station Drive
Charlotte, NC 28277
