Boarding Agreement

Boarding Agreement

Duluth Animal Hospital
Your Name*

First NameLast Name
Your Pet's Name(s)*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Emergency Contact : If you would like to leave us an emergency contact person that can make medical decisions on behalf of your pet (If none, please leave blank)

First NameLast Name
Emergency Contact's Phone Number (if none, please leave blank)
Please enter a valid phone number.
Drop Off Date*

MonthDayYear
Date
Pick Up Date*

MonthDayYear
Date
Estimated Pick Up Time (Pick Up begins at 9:00am Monday-Saturday)*

Hour Minutes

AM/PM Option
If anyone else has permission to pick-up your pet, please leave us their name(s) :
Medical Information
Do we have permission to examine and treat your pet if a medical problem should arise during their stay?**

YesCall First
*Charges will apply. If indicated, we will attempt to call you prior to treatment. If unable to reach you, we will treat your pet's medical problem and advise upon your return. In case of emergency, we will begin treatment until you can be reached for further instruction.
Does your pet need any medical services performed while here with us?*

YesNo
If yes, please explain :
Please describe any medical services your pet needs.
Did you bring food?*

YesNo
If yes, what kind?
Brand/Type
Does your pet eat a prescription diet? (If hospital provides prescription diet, additional cost)*

YesNo
How many times per day is your pet fed?*
Amount per feeding :*
Please list any medications we will be administering to your pet during boarding. (We can only administer medications provided in their original bottle with label)
Item Inventory
At no extra charge, Duluth Animal Hospital provides a high quality, general care diet, stainless steel bowls, bedding, toys, and leashes for your pet during their stay. We would prefer no bedding be left with your pet. If you do choose to leave items, Duluth Animal Hospital is not responsible for items lost or destroyed by pets during their stay.
Please list any items you are leaving.
Additional Services
Bathing Services : Please check any of the following you would like us to perform during your pet's stay.

Nail trim only ($18.75)Anal gland expression only ($28)Bath ($35-55). Baths include nail trims, gland expression, ear cleaning, blow dry and brush out. No hair cutting, plucking, or shaving services are provided.
Boarding Release Information

Please indicate that you agree to the following :
I understand my pet must have proof of current vaccinations/testing : Rabies, DHPP, Bordetella, and Influenza for dogs or Rabies and FVRCP for cats) as well as a negative fecal in the last 12 months for dogs. If proof of vaccination is not provided, the doctor will perform a physical exam and administer vaccines at owner’s expense to prevent the spread of illness between boarding pets.

If my pet shows evidence of internal or external parasites (ticks, fleas, or worms), my pet will be examined and treated appropriately during his/her stay.

I understand that Duluth Animal Hospital provides utmost caution against illness, injury, or escape. However, there is always some level of risk when pets come into contact with other animals. I will not hold them liable or responsible in the care or treatment of my pets, and I assume all risks associated with pets coming into contact with other animals. This includes Kennel Cough (Bordetella), upper respiratory infection, Influenza, parasites, diarrhea, weight loss, etc.

Photos and videos are sometimes used to capture daily fun and activities. By signing this form, I hereby grant Duluth Animal Hospital permission to use my pet’s likeness and name in photograph, video, or other digital or print media, without payment or consideration. I understand all photographs remain property of DAH. I hereby irrevocably approve Duluth Animal Hospital to edit, copy, exhibit, publish, or distribute these photos for any lawful purpose, and waive any compensation.
By signing, I acknowledge that I have read and agree to the above information. I verify that I am the owner or agent of the pet in question, and I am 18 years of age or older. *

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Boarding Agreement

Medical Information

Item Inventory

Additional Services

Boarding Release Information