BOARDING RELEASE FORM

Pet’s Name: ____________________________________ Pick up date: ________________________ AM / PM

Please call ahead if you need to pick up earlier than this date

Our Kennel has a “No Fleas/Ticks” policy. If your pet is found to have fleas/ticks, they will be treated.

The cost ranges from $6- $20. If your pet is on monthly flea/tick control please list the product and

when it was last given: ___________________________________________________________________________

Dogs that are boarded must have been vaccinated for Bordetella (kennel cough) within the last 6

months and DA2PP within the last year (three year vaccine accepted). Cats that are boarding must

have been vaccinated for Feline distemper within the last year. Proof of vaccine status is required. If

your pet is not current on these vaccinations, we can vaccinate at the time of admission.

Boarding pets are fed Science Diet Maintenance. If your pet has special nutritional needs, please

consult our receptionists.

Please list the amount and times your pet is currently fed: __________________________________________

__________________________________________________________________________________________________

Daily medications, if needed, will be given at a nominal cost. Please list name of medication your

pet is currently on and dosage instructions:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Boarding can be a stressful time for your pet. Gastrointestinal upsets and other problems can occur.

If your pet should have a problem while boarding, do we have permission to treat your pet?

PLEASE CHOOSE ONE: I DO AUTHORIZE TREATMENT I DO NOT AUTHORIZE TREATMENT

We do offer a “minor insurance policy” that takes care of medicine, exam charges, and medical

tests that are incurred as a result of the stress of boarding. This does not include worming,

vaccinations, or surgery. The cost of this insurance is $2.00 per day per pet. Do you want insurance?

YES NO

Any special instructions? __________________________________________________________________________

__________________________________________________________________________________________________

List persons authorized to pick up your pet: ________________________________________________________

Emergency phone number: ___________________ Signature: _____________________ Date: _____________

As an added convenience for our clients, we offer Sunday discharges. Pick-up time on Sunday is between 5pm-5:20pm only. There is a $20 charge for Sunday pick ups but there is no additional cost for the off-hour pickup. Please label items left with your pet.

** NOT RESPONSIBLE FOR LOST OR DAMAGED ITEMS THAT ARE LEFT WITH YOUR ANIMAL**