Boarding Agreement BOARDING AGREEMENT Arrival Date Date Format: MM slash DD slash YYYY Date of pick-up Date Format: MM slash DD slash YYYY Time : HH MM AM PM Owner*Pet's Name*Today’s Date* Date Format: MM slash DD slash YYYY Additional Services: (see below) $BatheYesNoGroomYesNoMedicationsYesNoCapstarInOutPet(s) Boarding: (Estimated Cost) Nights @ $Nights @ $Nights @ $Person(s) to contact in case of emergencyTelephone number(s)Special Instructions - include detailed medication directions, feeding instructions, and anything you wish the doctor to check for.VACCINATION POLICY To insure the protection of all pets under our care, the following must be up-to-date: Dogs Cats Birds Annual Exam DHPP Bordetella Rabies Canine Influenza Leptospirosis Fecal O&P + Giardia Annual Exam FVRCP Rabies Fecal O&P + Giardia Annual Exam Viral Screening (Psittacosis, Polyoma, PBFD) Fecal O&P + Giardia If not up-to-date, or unable to provide proof of vaccination, I give permission to update my pet(s) vaccination in accordance with the above policy. In addition, if any fleas/ticks are observed on you pet(s) while boarding, he/she (they) will receive treatment (Capstar or Frontline) at the owner's expense. Estimated Total: $MEDICAL ILLNESS POLICY One of the advantages of boarding your pet(s) at a veterinary hospital is that veterinary attention is readily available should the need arise. If your pet(s) becomes ill, we will call the emergency number(s) listed above regarding your pet's symptoms, treatment options and estimate of additional cost. If no one can be reached however, please indicate your wishes below should your pet(s) require treatment to relieve immediate discomfort or to resolve an important medical condition, (INITIAL) Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached. This includes only non-elective treatment and necessary diagnostics.I authorize up to (check one and indicate amount)*$200$300(INITIAL) Do not administer any medical treatment until specific authorization is given.I have read and understand this agreement. I fully intend to pick up my pet(s) on the above-specified date. If circumstances change, I will notify the veterinarian of a new pick-up date. I hereby authorized to pick up my pet/pets in case I am not available(payment/picture ID required) Signature*Date* Date Format: MM slash DD slash YYYY Special Instructions: Food: Wet Dry Both Hospital (EN dry)(Name of food)Did you already feed for the day?YesNoHow much do you feed?How often do you feed? 1x a day, 2x a day, all dayAmount given/ any other special instructions?Belongings:Meds: : NameHow many?What time?Do you give medication with food or treats?YesNoWere medications already given?YesNoAny other special instructions?Signature*
