Boarding Authorization Form

Date *

Date

Client Name *

First Name Last Name

Patient Name *

Name and Number for Primary Contact while boarding *

Emergency Contact Name and Number *

Date to be picked up

Date

Time to be picked up

Food for patient while in our care:

We will provide our own food at boarding intake We would like you to feed your in house GI low fat diet

Amount of food to be fed

How often do we feed?

Caine pets must be current on the following:

Rabies, Distemper, Influenza Bivalent and Bordatella. Proof of a negative annual fecal.

Feline pets must be current of the following:

Rabies, FVRCP (feline distemper) and if they go outside Leukemia.

I understand that updated vaccine records should be emailed to northaustinah@yourvetdoc.com 24 hours prior to check in to secure appointment.

*** We operate a flea free facility and in order to maintain this standard, we require proof of veterinary branded flea treatments for boarding. If you cannot provide proof of monthly applications we will administer a medication for fleas at an additional charge.***

I understand that I may be asked for a deposit of up to 50% of treatment plan/estimate at patient drop off. I also understand that payment is due at the time services are rendered and when my pet is released from the hospital. I know that I will be responsible for the entire amount of my pet’s treatment and agree to pay this amount in full upon discharge.

I authorize North Austin Animal Hospital to perform any procedures necessary for treating and maintaining my pet’s health and well being, while boarding here. I understand that the staff will stabilize my pet in an emergency and then try to reach me or my emergency contact as soon as possible for further treatment. While I expect all procedures to be performed to the best of the staff’s abilities, I realize the hospital makes no guarantee or warranty regarding the results. I understand there is a risk to many procedures, including anesthesia. If my pet should injure itself, escape, fail to eat, become ill or die, I do not hold North Austin Animal Hospital and its employees responsible. Payment is required at the time of pets are released from our care. Pets are released only during regular hospital hours.

Signature *

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