Boarding Request & Agreement Name* First Last Phone*Email* Emergency Contact Name* First Last Emergency Contact Phone*Drop Off Date Requested* MM slash DD slash YYYY Pick Up Date Requested* MM slash DD slash YYYY Dates requested are not guaranteed & we'll be in touch soon to verify if your selected date range is available. Please allow 48 hours for processing & confirmation. Thank you!Patient Name*Species* Feline CanineBreed*Services requested:* VAX Bath/Nail Trim Anal Glands Expressed Other NoneOther*We feed Hill's Science Diet but do recommend bringing your pet's food to reduce potential upset stomach. Tell us, how much food do you feed your pet daily? (quantity & number of times per day, or free feed):*If your pet is on medication, let us know the name, dosage & instructions (Note: please bring in ORIGINAL container):If your pet is taking supplements or other ingestibles, please tell us the name, amount & instructions (remember to bring these with you):Anything else we need to know about your baby to help them feel comfortable & at home – away from home?Please bring any toys, bedding, etc. to help your fur baby feel at home! Please bring all items in 1 bag, or label separate items with their first and last name.Reminders: Monnday-Friday: drop off/pick up is before 5:15 pm Saturday: drop off/pick up before 11:30am Sunday & major holidays: no drop off/pick upAgreementI understand that all reasonable precautions will be used to avoid any possible injury, escape, or death of this pet. It is agreed that the practice and/or staff cannot be held liable for any problem(s) that may develop, provided reasonable care and precautions are followed. I understand that ANY problem that is stated at time of drop-off, or any problem that may develop during the pet’s stay, will be treated as deemed best by the staff veterinarians. There will be a Boarding Exam Fee applied if your pet is treated by a veterinarian during his/her stay). I further understand that I ASSUME ALL RESPONSIBILITY for any associated expenses. Occasionally, there are times when your pet could develop diarrhea and/or vomiting due to nervousness from boarding, and being away from home. In some cases your pet may arrive with ear or skin conditions as well. We ask that you authorize treatment prior to leaving so there is no need to bother you while you are away. Please note – that if something more serious arises, we will contact you.It is our policy that all boarded pets must be current on those vaccines in order to be boarded at our hospital; I understand, and agree that if, at any time, my pet’s records indicate Rabies or Coughard vaccine(s) are due or past due, they will be brought current with that medication/treatment. IF YOUR PET IS NOT CURRENTLY ON A FLEA PREVENTATIVE, ONE WILL BE GIVEN. The fee(s) for these items will be charged at time of check-out.If you neglect to pick up your pet within 5 calendar days of the agreed on check-out date, and FAIL TO NOTIFY OR CONTACT US within said timeframe, it will be presumed that your pet has been abandoned. We are hereby authorized to place him/her as the hospital deems best. It is understood that doing so DOES NOT relieve you from paying ALL COSTS incurred.Please agree to the above:* I AgreeSignature*CommentsThis field is for validation purposes and should be left unchanged.Δ