Food and Medication Form

Parent's Full Name

Email

Pet's Name

Check-In Date

Check-Out Date

Medication #1 Name

Strength and Dosage

Time next dose is due

Medication #2 Name

Strength and Dosage

Time next dose is due

Medication #3 Name

Strength and Dosage

Time next dose is due

Did you bring your pet’s own food or are we feeding your pet our food?
 Own Food HPI Food

If you brought your own food, what kind is it?
 Dry Canned Both

Feeding Directions
 Once Daily (Morning) Once Daily (Evening) Twice Daily Other

Other:

How much food each feeding? (ex. 1 cup per meal)

When did your pet last eat?

We provide bedding, bowls, etc. We do not recommend leaving items at the hospital for your pet while boarding as some items can be misplaced when placed in the wash.

Description of the items you are leaving with your pet (toys, bedding, collar, leash, etc.):

Please note: Hickory Pet Inn is not responsible for the loss of these items.

Other Comments: