Boarding Release Form

Client Name*

Phone Number*

Please enter a valid phone number.

Arrival

MonthDayYear

Departure

MonthDayYear

Name (Pet 1)*

Species

Cat, dog, etc.

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

Name (Pet 2)

Species (Pet 2)

Cat, dog, etc.

Name (Pet 3)

Species (Pet 3)

Cat, dog, etc.

Name (Pet 4)

Species (Pet 4)

Cat, dog, etc.

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

Separate pleaseTogether is fine

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

Separate pleaseTogether is fine

Will you be bringing your pet's food, or would you like your pet to eat our food? (Note: we feed Purina EN and there is an additional fee of $7.00 per day.*

I will be bringing food for my petI would like my pet to eat Riverview Animal Clinic food during their stay

What type/brand food does your pet eat? (ex: Pedigree dry)

Feeding Instructions (list amount fed throughout the day). Please be specific (i.e. 1/4 cup AM, 1 cup PM, etc.) *

	AM Feeding	Midday Feeding	PM Feeding	Free Feed
Dry food amount
Canned food amount
Other

Is your pet currently taking any daily medication(s)? (Note: this is not including preventatives such as Heartgard, Nexgard, Bravecto, etc).*

YesNo

Medication Instructions (list medications given throughout the day). Please be specific (name of medication, strength, dosage. i.e. Vetprofen 25mg 1/4 tablet AM and 1 tablet PM.)

	AM Medication	Midday Medications	PM Medications
Medication Name Strength Dosage
Medication Name Strength Dosage
Medication Name Strength Dosage
Medication Name Strength Dosage
Medication Name Strength Dosage

Will you need any medication or food refills during your pet's stay? If so, please list medication or food type below.

Would you like your pet to have a bath during their stay?*

YesNo

Bath Type (pricing based on pet's species/weight and additional charge for medicated or oatmeal shampoo).

RegularMedicatedOatmeal

Would you like your pet to have TLC during their stay? (TLC is additional one-on-one playtime with a staff member, cost is $11.50 per day).*

YesNo

By initialing below, I acknowledge that I am permitted to bring no more than two belongings for my pet during their stay (e.g., blanket, bedding, toy, carrier). I understand that food, medication, and other necessary items are not included in this limit. Riverview Animal Clinic provides bedding, bowls for food and water, and toys for TLC time. To ensure patient safety, I understand that toys will not be kept in runs overnight.*

Initial Here

Please list the first item you will be bringing for your pet (if applicable):

Please list the second item you will be bringing for your pet (if applicable):

Do we have permission to treat in the event of a non-emergent injury or illness, or do you prefer to be called first (i.e. Diarrhea, vomiting, GI issues, or anxiety)?*

Proceed with treatment, I do not need to be called firstCall me before any treatment

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.

In the event that we are unable to get in contact with the owner, 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 provided. If we are unable to verify this information, necessary vaccinations will be administered upon admittance at the owner's expense. Additionally, a negative fecal examination is required for all boarding patients. If this has not been confirmed, we will conduct the necessary test during your pet's stay, also at the owner's expense.

Please be advised of the following:

Prices listed on this form are effective as of January 1, 2024.
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 $7.00 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) unless otherwise specified by owner.
We will feed on departure day at set feeding times unless otherwise noted.
Baths are performed the day of scheduled departure. Pickup should be planned for after 3pm unless otherwise requested.
If your pet does become ill, 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.
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.
During holidays and peak seasons, all boarding reservations will need to be made with a 2-night minimum stay.
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.
We are closed on Sundays. Sunday boarding pickups can be scheduled between 4:00 pm - 5:00 pm.

By signing this document, you acknowledge that you have read, understand, and agree to the terms listed above.

Emergency Contact Name*

Phone Number*

Please enter a valid phone number.

Would you like to keep this form on file to use for future boarding reservations through the remainder of the year 2025?*

Yes, I authorize to use this information for future boarding visits through 2025No, I anticipate boarding instruction changes and understand I will need to complete this form again in the future

Please list any additional comments/concerns/instructions for us during your pet's stay in the box below:

Signature of Owner or Person Responsible*

Boarding Release Form

Client Information

Pet Information