Boarding Release Form

Pick up/Drop Off: Monday-Friday 8am-5pm
Special Pick Up: Saturday, Sunday 9am-9:30am only ($30 special discharge fee)
All first time boarders are required to pass a "Trial Board" session prior to boarding. Call us for more information.

Please fill out the form below prior to your pet's boarding reservation. It is important to us that your pet is as comfortable as possible during their stay. Please be as detailed as possible with your responses. Thank you and see you soon!

Name*

First NameLast Name

Pet(s) name(s)

Drop off Date*

Date

Hour MinutesAM/PM Option

Pick up Date*

Date

Hour MinutesAM/PM Option

Phone Number*

Please enter a valid phone number.

Emergency Contact (this person has the aforementioned owner's permission to make medical and financial decisions in the event that the owner cannot be contacted)*

First NameLast Name

Emergency Phone Number *

If you plan on bringing some things from home, please take a photo of the items so that we can label them for your pet.

Description of belongings

Please list all medications, frequency given, and any other medication notes.

Feeding instructions:

I would like my dog(s) to be exercised in the enclosed yard. (Initial below)

I would like my dog(s) to have additional playtime each day ($5.00/15 min). Yes (number of times) No

Has your pet shown any signs of:*

Are there any behaviors (good or challenging) that we should be aware of while your pet is boarding? (ie: digging, anxiety, chewing, shredding bedding) Details:

My pets need to be boarded separately: (I understand there is inherent risk allowing my pets to board together and by selecting ÿes" understand Beaver Meadow Veterinary Clinic will use all reasonable precautions and will not be held responsible for injury/death as stated in the signed Boarding Release agreement below.)

YesNoSeparated when eating

Beaver Meadow Veterinary Clinic Boarding Release Form:

Beaver Meadow Veterinary Clinic will use all reasonable precautions against illness, injury, or escape of your pet and will not be held liable or responsible in any manner whatever, or any circumstances, on account of the care, treatment, or safe keeping of him/her/them as it is thoroughly understoon that I assume all risks.

In care of illness, injury, or death, I, the undersigned hereby give my consent for the veterinarians of Beaver Meadow Veterinary Clinic to treat, prescribe for, operate on , or dispose of him/her/them while he/she/they are being boarded at Beaver Meadow Veterinary Clinic.

Should the circumstance arise that he/she/they remain unclaimed after the date which I stated as the pick up date, I understand that written notice will be mailed. Seven days after such written notice, he/she/they will be considered abandoned and property of Beaver Meadow Veterinary Clinic. I understand that if such further action is taken place it place I am responsible for all costs incurred during the scheduled boarding period.

I understand that I am responsible for the cost of any repair of any damages caused by him/her/them in excess of normal wear and tear. I also understand that Beaver Meadow Veterinary Clinic is not to be held responsible for any pet belongings left behind, damaged by the pet while boarding. I also understand that if my pet should have fleas, he/she/they will be treated and I will be responsible for costs incurred.

Beaver Meadow Veterinary Clinic leash walks or allows free play all dogs within a fully enclosed 6' high chain link exercise area. Dogs with the following conditions: jumpers/climbers, diggers, or others that can excape dog run enclosures, behavior problems, bee allergies, eats gravel/rocks will only be leash walked.

I have read and understood the Boarding Release Form and have filled out its contents completely and accurately.*

Clear