Boarding Agreement

Boarding Agreement
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Owner's Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Pets Name (List all that are boarding)
Admission Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Discharge Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Emergency Contact Other Than Owner

First NameLast Name
Emergency Phone Number

Area CodePhone Number
All animals admitted must be current on vaccinations and free from internal and external parasites. Any animal found to have parasites will be treated at the owners expense.
(Please initial stating that you understand)
There is an additional charge for dropping off or picking up pets while hospital is closed. These arrangements must be made beforehand and prepaid. Drop off and pick up times are at 8 AM OR 5PM ONLY. The charge for picking up when closed is $25. THERE ARE NO PICK UPS OR DROP OFFS ON HOLIDAYS
(Please initial stating you understand)
There are additional charges for administering medications to your pet while in our care. Medication Level 1 - Additional $7 per day (Once daily administration - up to 3 medications) Medication Level 2 - Additional $12 per day (Twice daily administration - up to 3 medications) Medication Level 3 - Additional $17 per day (Administration more than twice daily and/or more than 3 different medications) *All medications brought in for boarding must be in original containers*
(Please initial stating you understand)
Will your pet require medications while boarding with us? If so please list medications below with their instructions.
Does your pet need medical treatments while boarding? Exam, vaccines, etc.
Does your pet need any of the following services while boarding?
Martin Downs Animal Hospital is not responsible for personal belongings that are lost, damaged, or soiled during boarding. Although we will make reasonable efforts to return all belongings in good condition, bedding, blankets, toys, bowls, leashes, carriers, and other items may become damaged or soiled. Please label all belongings with your last name and your pet’s name. List all belongings being left with your pet. Enter “None” if applicable.
Please label all belongings!
What are your pet’s feeding instructions?
Own food/kennel dry food, how much, how often?
Has your pet had any coughing or sneezing? (Signs of an upper respiratory infection?)
Is there anything else you would like us to know about your pet while they are boarding?
I fully intend to pick up my pet on or around the above date specified. If circumstances arise which require a change in dates, I will notify the veterinary hospital of a new pick up date. Reasonable precautions will be used against injury or death of your pet while boarding. Martin Downs Animal Hospital and staff will not be held liable for problems that my develop during your pet's stay provided reasonable care and precautions are followed. I understand that any problems that may develop with my pet while boarding will be treated as deemed best by the staff and veterinarians. I assume full responsibility for all expenses incurred. All costs shall be paid on release of the pet for boarding and all other treatment necessary.
(Please initial stating that you understand)
I understand that while every effort is made to prevent illness, dogs may become sick during or after boarding, as some contagious diseases have an incubation period and may not show signs until after they return home. If my pet requires examination, diagnostics, treatment, or medication related to an illness that develops during or after boarding, I understand that I am financially responsible for all associated veterinary costs.
(Please initial stating that you understand)
If my pet becomes ill or injured, I authorize Martin Downs Animal Hospital to attempt to contact me and my emergency contact using the information provided. If neither of us can be reached, I authorize the veterinarian to provide care considered reasonably necessary for my pet’s health and safety. I understand that I am financially responsible for all examinations, diagnostics, medications, treatments, and other services provided.
If we are unable to reach you, what is the maximum amount you authorize for your pet’s medical care?
Signature of Owner/Agent
Today's Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: