Boarding Contract

DROP OFF AND PICK UP HOURS

Monday thru Friday: 8:00 am to 6:00 pm

Saturday: 9:00 am to 12:00 pm

NO SUNDAY PICK UPS OR DROP OFFS

ALL MEDICATIONS MUST COME IN THEIR LABELED BOTTLES.

Please do not put medication in baggies or in containers with the name written on, we will be unable to give that medication.

Owner's Name*

First NameLast Name

Best Contact Phone Number*

Please enter a valid phone number.

What is the best way to contact you?*

Phone CallText MessageEmergency ContactOther

Emergency Contact (CANNOT BE SELF - if you are going out of town, please try to have emergency contact be someone who will be in town)*

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.

I authorize my emergency contact to:*

Pick up my pet(s)Make medical and financial decisions for my pet(s)All of the above

Best way to contact?

Phone CallText MessageOther

Check In Date

Date

Check Out Date

Date

PET INFORMATION

If you are boarding more than one pet please enter the additional pets on the following page!

Pet's Name

Species

CanineFeline

Breed

Sex

Intact MaleNeutered MaleIntact FemaleSpayed Female

Colors +/- Markings

Food

We provide Purina Pro Plan EN Gastrointestinal Diet dry food at no additional cost. However, we do recommend bringing your own food to avoid possible gastrointestinal upset. You will need to bring your own food if it is a prescription diet.

Any canned food we provide will be an additional charge.

Please be advised that any food requiring additional preparation or cooking may incur an additional charge.

Will you bring your own food or will your pet be eating our kennel food?*

We brought our own foodPlease feed the kennel food

Feeding instructions: How much and how often? If free fed, please still provide an amount.*

Example: 1 cup twice daily or 1 cup daily free feed

If you brought your own food, what brand is it?

If you brought your own food and it runs out during their stay, how would you like us to proceed?

Please feed the kennel food (does not include wet food)Please refill the prescription diet if able (if unable, we will contact you)Contact me and I will have someone bring foodContact my emergency contact to bring food

Additional Information and Medications

Administering 3 or more medications a day may incur an additional fee.

Certain medical conditions,such as Diabetes, that require extra care may be charged for Special Accomodations.

Does your pet have any allergies?

Do you authorize Animal Medical West to give Peanut Butter and/or Spray Cheese for a fear free boarding experience*

YesNoOther

Is your pet on any medications/supplements? If so, please list the name and instructions.

Example: Trazodone- 1 tablet twice daily

Do you need any medications or preventatives refilled during this stay? (Only for clients of the hospital)

Has your pet shown any symptoms of, or been diagnosed with, an illness in the past 30 days? If yes, please elaborate.

Please acknowledge that your pet is up-to-date on flea prevention. If any fleas are found on pet, treatment will be applied at the owner's expense.*

Acknowledged

Please acknowledge that Animal Medical West will not be held responsible for lost or damaged personal items left with pet.*

Acknowledged

Please list any items you are leaving.

GROUP PLAY

Group play is intended ONLY FOR SPAYED/NEUTERED dogs that interact well with others.
Intact dogs under a year old may still join group play.
Intact females under a year old will still be separated if in heat.
Animal Medical West will provide sufficient staff to monitor all play groups and will do our best to screen dogs prior to entry into group play. However, any information on previous positive and/or negative experiences with other animals is extremely important in allowing us to provide a safe and fun environment for your animal.
It should also be understood that any time that dogs interact with each other, there is a risk for injuries including scratches, bites, and/or other life-threatening trauma.
Animal Medical West strictly requires all of the boarding, grooming, and daycare animals to be current on vaccines and intestinal parasite/flea control. However, there still remains a risk of the transmission of upper respiratory infections, diarrhea, flea, and other communicable diseases.
Animal Medical West will not be held financially responsible for any expenses that may occur should your animal suffer any injury or illness due to their involvement in group play.
Injuries will be treated by the veterinary staff at the owner’s expense and will be contacted as soon as possible.

Do you authorize your spayed/neutered pet for group play?*

YesNoOther

Is there anything pertaining to your pets behavior with other animals and/or humans that we should know about?

Do you wish to have your pet groomed?

YesNo

IN CASE OF EMERGENCY

In the event of an emergency, I select the following resuscitation option:*

I give permission for life sustaining procedures and assume financial responsibility for these procedures.I do not give permission for life sustaining procedures and understand that in such cases the veterinarian deems necessary, my pet may be euthanized to end their suffering.

Disaster Agreement

In an effort to provide you, our client, with our mission in the event of a disaster, the following plan has been developed.

1. Plan to take your pet with you. Public shelters will not allow pets.

2. If you are going to evacuate, make arrangements for your pet in a non-evacuation zone.

3. If your pet is boarding, we will need an emergency contact person who would be able to pick-up your pet, if our facility is ordered to evacuate.

4. If your pet is boarding and you are unable to make arrangements for your pet to be picked up, we will not be able to evacuate your pet to a designated non-evacuation zone.

5. If evacuated, your pet will be temporarily housed in an air-line approved pet carrier or crate. The crate shall be solid on all sides with a grated metal door and holes for ventilation.

6. We suggest that owners prepare a disaster pet supply kit to assist us in our efforts to provide care for your pet.

7. Using the emergency phone number indicated on your boarding form, and pending communication systems are functioning, you will be updated on the welfare of your pet.

8. We make no implied or expressed guarantee that our facility could withstand a disaster. Every effort shall be made to protect your pet as well as the employees of Animal Medical West.

9. A “Category-3” hurricane has sustained winds of 111-130 mph and is considered a major hurricane. In the event of such a hurricane, animals will be secured and personnel will be instructed to go home and seek shelter.

10. Mild sedation may be required for some pets; sedation will be administered at the discretion of the veterinarian. It is in your pet’s best interest to remain calm.

11. If our facility is damaged, and your pet is injured, we will make every effort to provide first aid.

12. If your pet is severely injured, and we are unable to provide advanced medical care for whatever reason, at their discretion, our veterinarians will humanely euthanasia your pet. Caring for your pet is our utmost concern; however we do not want any pet to suffer.

ACKNOWLEDGEMENT:

I am the owner, or agent for the owner, of the above-described animal and have the authority to execute this acknowledgement. I hereby authorize Animal Medical West to medicate, anesthetize, treat and perform any surgical procedure(s), as are in the opinion of the veterinarian, necessary and advisable for my pet’s health in the event of an emergency. I accept all procedures to be done to the best of the abilities of the professional staff, and I realize that no guarantee or warranty can ethically or professionally be made regarding the results or outcome. I assume all financial responsibility, and understand that payment is due upon completion of service.

Owner acknowledgement and acceptance.*

Acknowledged and Accepted

OWNER RELEASE:

("I" refers to the Pet's Owner) Animal Medical West will use all reasonable precaution against injury, escape, or death of my pet. Animal Medical West and its employee's will NOT be held liable for any problems that develop during my pet's stay provided reasonable care and precautions are followed.

Pets may become ill while boarding, in addition, but not limited to being exposued to communicable diseases. Every effort will be made to contact you should your pet become ill or injured while boarding, however you are responsible for any charges incurred while treating your pet and agree to hold the staff of Animal Medical West harmless from expenses incurred.

Pets that become excessively soiled while boarding will be bathed, if necessary, at the client’s expense.

Dogs sharing a run may be subject to an additional charge by night if we must separate due to aggression or having to be separated or monitored during meal times.

Though every attempt will be made to reach you, should problems arise in your absence, we will perform any necessary treatment to ensure your pet’s good health. A change in hospital status may need to occur based on the veterinarian’s medical assessment (i.e. to medical boarding or hospitalization). This would necessitate additional costs for medical treatment and nursing care.

I release the Animal Medical West of all liability should my pet’s life be lost due to unforeseen situations, including fire and natural catastrophe.

I understand that if I neglect to call or pick-up my pet after five (5) days of the stated discharge date, the Animal Medical West will assume that I have abandoned my pet. I understand the Animal Medical West will abide by standard legal steps for abandoned pets. Furthermore, I agree to pay any additional charges incurred after said intended discharge date, whether or not I collect my pet within that 5-day period.

I understand in some circumstances a monetary deposit will be required prior to boarding stay.

Furthermore, I agree to pay the balance in full upon discharge from Animal Medical West.

I understand that I am free to call at any time during my pet’s stay at Animal Medical West for updates regarding my pet.

If I would like to visit my pet while boarding, I have been informed that I must call to schedule visitation. I understand that in the event that an emergency arises with another patient during my visit I may be asked to leave.

Please sign below acknowledging that you are familiar with these boarding policies, accepting all risks and responsibility for any costs incurred while your pet is under the care of Animal Medical West.

Name*

First NameLast Name

Date*

Date

Signature*

**IF YOU ARE BOARDING ONLY ONE PET, PLEASE CLICK "SUBMIT" BELOW.

IF YOU ARE BOARDING MULTIPLE PETS, PLEASE CLICK "NEXT" TO GO TO THE NEXT PAGE TO ADD MORE PET INFORMATION. DO NOT CLICK "SUBMIT" UNTIL YOU ARE FINISHED ADDING ALL PETS THAT WILL BE BOARDING WITH US.