Boarding Consent Form

Boarding Dates

Date of Drop-Off:

Date of Pick-Up:

Owner Information

Patient Information

CanineFeline

Feeding Instructions-(Must include measurable amounts and frequency of feeding. Example: 1 cup twice daily, morning and night.).

OK to feed HF if needed

Enrichment & Add-Ons (Additional Cost)

Would you like to add enrichment?
Enrichment is
YesNo
Nail Trim (N/T)Anal Gland (A/G)Bath

Personal Items

HarnessLeash

Vaccination Status

RabiesBordetellaParvoDistemperFecalInfluenza (Recommended)Feline Distemper

Medication

Refill Medicaiton?
YesNo

Medication Fee Acknowledgment

I understand that there is a fee of up to $11 per pet, per day for medication administration.

Initials:

Other Concerns

** PLEASE NOTE **

50% Deposit required for boarding of 7 days or greater.
Medication administration during boarding are charged a fee of up to $ 11 per pet, each day.
Do not leave your collar, leash or items of personal value. We will not be responsible for damaged or lost items.
I understand that there is an inherent risk of escape with leash exercise walks.
Reasonable precautions will be used against injury or escape of pet.
I grant permission for any necessary vaccines that are required for boarding as outlined above.
I grant permission for any emergency treatments needed while my pet is boarding.
I understand I am financially responsible for all charges that are acquired for treatments performed to my pet and that payment in full is due at time of pick up for all services rendered during my pet's stay.

Emergency Contact:
Someone other than the owner listed above that can be contacted in case of emergency
when the owner cannot be reached.


Is your emergency contact authorized to make medical decisions?

YesNo

Email Boarding Updates

I opt in for e-mail boarding updates.

If yes, enter email:

Agreement

I acknowledge that all the information provided is accurate and I agree to the terms listed above.

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