CF Olson Associates LLC DBA
PurrInn Cats I
Hostelry
FILE #
INTAKE FORM
COMPLETE ONE INTAKE FORM FOR EACH CAT
OWNERS NAME: _____________________________________________________________ DATE: SPOUSE'S NAME OR OTHERS IN HOUSEHOLD: NAME OF PERSON/S AUTHORIZED TO PICK UP CAT/S HOW MANY CATS WILL BOARD? CAT’S NAME: WEIGHT: SEX: BIRTHDATE: COLOR; Is your cat SPAYED/NEUTERED? AGE CAT OBTAINED: If more than one - SHARE CONDO? BREED: LONG SHORT OR MEDIUM LENGTH HAIR? DECLAWED? FROM: WHAT? LEUKEMIA: FLEA TREATMENT INDOOR ONLY?
Cats older than 8 months must be spayed/neutered
Does your cat have any HEALTH CONDITIONS? DATE OF LAST: FVRCP: RABIES:
No Cat Will Be Allowed in the Cat Boarding Kennel Area without current confirmation of vaccinations for FVRCP
within 1 year and RABIES within 3 years and confirmation that the cat is spayed/neutered on a licensed veterinarian’s receipt or printout. Feline Leukemia vaccination is recommended but not required. All vaccinations should be given at least two weeks prior to boarding. If your cat needs an updated inoculation, it should be done at least 72 hours prior to boarding. Your Cat's Veterinarian can FAX this information to us at 425-806-8135. If your cat is found to have fleas or ticks, you authorize their removal at your additional expense. In addition, we require you to confirm that your cat/s is in good health and free from and has not been exposed to rabies, or any contagious illness within 30 days prior to beginning its stay with us. Cats with infectious diseases, such as distemper, upper respiratory disease, or worms will not be allowed. DIET: BRAND: CAN AMOUNT: AM. CAN DRY DRY PM. CAN DRY
We will provide dry food for all cats or if your cat/s is on a special diet or is picky, you are welcome to bring your cat/s preferred brand of canned and/or dry food and/or treats. All Food, Treats, Medications and Vitamins must be labeled with your cat’s name, directions and amounts and placed in zip lock bags or small plastic containers, (preferably single serving per bag for food) for the amount needed plus a little extra. Does your cat tolerate changes in brands of foods? LITTER What type is your cat accustomed to? Non-Clumping Plant Based Clumping Plant Based Clumping Clay
IS THERE ANYTHING ELSE WE NEED TO KNOW ABOUT YOUR CAT/S? Fear of thunder, Epilepsy, Deafness, Sight problems, Allergies, Daily Activities, Rituals, &/or Secrets, Behavioral Characteristics that should be noted. BELONGINGS: List any items you are leaving with us. All items are left at your risk and should be labeled with cat/s first and last name. SPECIAL SERVICES: 10-minute Brush/Play time: Times / day View Condo preferred?
15-minute Brush/Play time: Times / day Medication administration: doses per day Complete a Medication Record Form for each medication to be administered. We do not administer injections or subcutaneous fluids.
Main Contact Signature Date Spouse or Partner Signature Date
Print Name
Print Name
PurrInn Cats Hostelry, Bothell, WA 98021 PH - 206-660-6475 FX - 425-806-8135 PurrInn@PurrInnCats.com www.PurrInnCats.com 4 of 7