Boarding Release Form

Client Name*

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Phone Type

Arrival

MonthDay Year

Departure

MonthDay Year

Name*

Species

Cat, dog, etc.

Breed

Sex

Color

Markings

Are you boarding multiple pets with us during this time?

Yes, I have more than one pet to boardNo, I just have one pet to board

Should we feed your pets separately or in the same run?

Separate pleaseTogether is fine

Bath

YesNo

TLC

YesNo

List any medications your pet is currently taking (include dosage and frequency).

Diet (include brand, amount given, and how often)

Please understand that occasionally some pets may develop minor and major problems while boarding. We will respond to the best of our knowledge and ability to ensure their welfare and health. We will also try to communicate with the appropriate people regarding any major medical problems.

I authorize Riverview Animal Clinic to provide and administer any necessary care regarding my pet(s) comfort, health, and well being. Pets must be current on all vaccinations required for boarding. We will make every attempt to verify your pet's vaccinations based on the information you have given us. If we are unable to verify this information, necessary vaccinations will be given upon admittance at the owner's expense.

By signing this waiver, you understand and agree to the following terms:

If your pet does contract a contagious illness, you will be financially responsible for costs associated with medical treatment
You will advise our staff if your pet is experiencing or has experienced any upper respiratory or other abnormal symptoms within the last 14 days
You understand that boarding policies may change or be limited depending on circumstances

Please be advised of the following:

There is a charge to administer medication to your pet while boarding. The cost is determined by how many times a day the medication is given. If you do not bring your own medication, it will be prescribed from our pharmacy and billed to your account.
There is a $3.50 charge per day if feeding our food during your pet's stay. If you provide food and your pet runs out while here, we will feed our food (Purina EN).
Baths are done the day of scheduled departure. Pickup should be planned for after 2pm unless otherwise requested.
If your pet is boarded over a holiday and is not picked up on the scheduled departure date, a one-time additional boarding fee will be added to extend the reservation. To avoid this fee, please contact us in advance prior to end of day on the scheduled departure date.
Animals left over 10 days beyond their pickup date, without communication from you, will be considered abandoned and disposed of in whatever manner becomes necessary.

Emergency Contact Name*

Phone Number*

Please enter a valid phone number.

Signature of Owner or Person Responsible*

Clear

Boarding Release Form

Client Information

Pet Information