Full range of
pet care and emergency services

Cats
Dogs
Avian and
Exotic pets

Serving the
Los Angeles
Community
Since 1969
10737 Venice Bl.
Los Angeles, CA 90034
 (310) 559-3770

Center-Sinai Animal Hospital TimeSaver Form: BOARDING INFORMATION 
Fill in here by printing, and fax to (310) 559-9447, or bring in with your pet.
(You can also copy and paste into Word to fill out).
IMPORTANT: Please note this form is to help save you time when you drop off your pet.
You must call to be sure you reserve the dates for boarding: 310-559-3770.

CLIENT NAME 

PET(s) NAME(s) 

BOARDING FROM UNTIL

EMERGENCY PHONE NUMBER    
EMAIL REQUIRED*  

DO YOU REQUIRE AFTER HOURS PICK-UP?  YES    NO    TIME 

FLEA BATH ON PICK-UP? (RECOMMENDED)  Yes   No

IS YOUR PET ON A SPECIAL DIET? YES   NO    IF SO, DESCRIBE:
 

IS YOUR PET ON ANY MEDICATION?  YES        NO 

IF SO, PLEASE LIST MEDICATION AND FREQUENCY OF DOSAGE

1. 
2.  
3. 

HAS YOUR PET BEEN MEDICATED TODAY? YES     NO 
ANY SPECIAL INSTRUCTIONS? 

WE DISCOURAGE LEAVING BLANKETS AND TOYS AND CANNOT ASSUME
RESPONSIBILITY FOR ITEMS LEFT HERE.
NY ITEMS THAT ARE LEFT MUST BE PERMANENTLY LABELED BY THE CLIENT.

WE WILL GLADLY PROVIDE ANY BLANKETS OR TOWELS
THAT YOUR PET NEEDS FROM OUR OWN SUPPLY.

DOGS                  UP TO 24 LBS – $17.50 /DAY  25-44 LBS. – $18.50/DAY
                           45 - 75 LBS. - $21.50/DAY     76+ LBS. – $22.50/DAY

CATS                  $15.50/DAY
                     
2ND PET OCCUPYING SAME CAGE $2 OFF

MEDICATION CHARGES:    ONCE DAILY $10
TWICE DAILY $12 ADDITIONAL THREE TIMES DAILY $13 ADDITIONAL

 PICK UPTIME IS 12 NOON TO
AVOID ADDITIONAL CHARGES

CLIENT INITIAL
 LEASH          CARRIER          TOYS           BLANKET       FOOD     
OTHER