Boarding Agreement

Today’s Date
Date of pick-up
Time
Owner*
Pet(s) Boarding
Bath
- Yes
- No
Medications
- Yes
- No
Person(s) to contact in case of emergency
Emergency telephone number(s)
Pet’s belongings (Carrier, toys, etc.)
Special instructions – include detailed medication directions, feeding instructions, and anything you wish the doctor to check for:
For Your Pet’s Health
VACCINATION POLICY
To insure the protection of all pets under our care, the following must be up-to-date:
DOGS: Rabies, DHLPPC, Bordatella, Fecal Exam, Heartworm Test, Canine Influenza vaccinations CATS: Rabies, FVRCP, Fecal Exam, FIV/HW Test If not up-to-date, or unable to provide proof of vaccination, I give my permission to update my pet(s) vaccinations in accordance with the above policy. In addition, if any fleas/ticks are observed on your pet(s) while boarding, he/she (they) will receive treatment at owner’s expense.
For your pet’s comfort we offer a complimentary anti-anxiety medication. If you’d prefer for your pet not to have this please indicate with your initials
MEDICAL ILLNESS POLICY
One of the advantages of boarding your pet(s) at a veterinary clinic or hospital is that veterinary attention is readily available should the need arise. If your pet(s) become ill, we will call the emergency number(s) listed above regarding your pet’s symptoms, treatment options and estimate of additional costs. If no one can be reached however, please indicate your wishes below should your pet(s) require treatment to require immediate discomfort or to resolve an important medical condition
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 treatments and necessary diagnostics.
I authorize up to (check one and indicate amount) in medical care for my pet(s) until someone can be reached.
Yes
No
$100
$200
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.
Date
Signature

This iframe contains the logic required to handle Ajax powered Gravity Forms.

Boarding Agreement

For Your Pet’s Health