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Would your pets like to board together or separately (This is only with your permission)

Together
Separately

Your Name

Phone Number

Email

Emergency Contact

Emergency Phone

Address

City

State

Zip

Pet's Name

Other Pets Being Boarded

Drop Off Date

Pick Up Date

List of Items Brought:

Would you like your pet to eat the clinic diet or will your provide your pet with their own diet?

Clinic Diet
Owners Diet

How often and how much do we feed?

AM
PM
Free Feed

How much?

If you checked Owner's Diet, please list the food that will be provided.

Please list any food allergies your pet may have

Will you bring a carrier for your pet?

Yes
No

Medications

No medication
Brought medication
Administer clinic medication
I administered this mornings/today's medications before arrival

List Medications

Please list any medications your pet may need to take (include when your pet needs their dosage)

Additional Services Requested

When should your pet be groomed?

What medical services does your pet require?

Information about your pet's behavior

Eats toys or bedding
Fearful of storms/fireworks
Dog aggressive
Plays well with others

Boarding Release

Boarding Policy and Release

Fleas/Ticks: To remain a flea and tick free environment, any pets entering our facility with these parasites will be treated at the owner's expense.

Medications: There is a daily $2.00 charge for the administration of medication to pets while in boarding. All medicines must be given to our staff at check-in with detailed instructions on how they are to be administered.

Feeding: Any special food needs to be provided by the owner in prepackaged bags. Otherwise, all dogs boarding are fed dry Hills Sensitive Skin and Stomach. This is a sensitive stomach diet to help prevent stress induces diarrhea. All cats boarding are fed dry Hills Feline Sensitive Skin and Stomach.

Supplies/Toys: All necessary supplies for boarding are provided. Personal items may be brought, but we are not responsible for lost or damaged items.

Cancellation Policy: Reservations must be cancelled within 24 hours or the owner will be charged for the first night of the reservation.

Emergency Treatment: In rare cases, emergency treatment may be needed for your pet while boarding.

In the event my pet becomes ill, I authorize the attending veterinarian to administer treatment as is considered therapeutically and/or diagnostically necessary. I also consent to the administration of such anesthetics, as are necessary and surgical procedures of an emergency nature. I understand that the Doctors or Staff will make every effort to contact me prior to any treatment or medication over a cost of $100.00 and/or surgical care of major medical emergency.

I agree to pay for any and all vaccinations that are deemed necessary for my pets stay.
If a medical problem is discovered during my pets stay, I understand that care will be provided and I agree to pay for all necessary treatment.
I agree to pay for flea treatment if fleas or flea dirt are found on my pet on admission or during my pets stay.
I understand that boarding rates are charged by the night.
I agree to pay in full for all services rendered at the time of discharge.
I understand that there are no pick ups outside of the Normal Business hours.

I agree to hold harmless any and all persons who might assist in the care of my pet, or from any claim or damages and/or administration of medication deemed necessary by the attending veterinarian. I understand this may include anesthesia. I understand the cost of treating my pet is a lawful debt. Therefore, I agree to pay any costs associated with procedures done while my pet is in boarding. Should I fail to pay at the time of discharge, I acknowledge that I am responsible for any collection agency fees (33.33%), attorney fees, and any court costs acquired due to the pursuit of payment. I allow Britt Animal Hospital and/or its agents to contact using any means I have provided on my account, including phone calls, text messages and emails, with the understanding they may be automated or artificial voice recordings.

Acceptance

I acknowledge and agree to the terms and conditions of service