Medical Boarding Contract

Medical Boarding Contract

Duluth Dog Depot
IMPORTANT : This form is for pets who we will be administering medications to during their stay or who have been reserved for medical boarding. If your pet is not on a medication or reserved for medical boarding, please use the standard boarding form HERE.

Please only fill this form out AFTER you have a confirmed reservation scheduled with Duluth Dog Depot.
Client Name*

First NameLast Name
Phone Number (that we can reach you in case of emergency)*
Please enter a valid phone number.
Secondary Phone Number (Optional)
Please enter a valid phone number.
Pet Name(s)*
Arrival Date*

MonthDayYear
Date
Departure Date*

MonthDayYear
Date
Pick-Up Time (After 12pm, nominal late checkout fee assessed, unless bathing or grooming service is being performed)*

Hour Minutes

AM/PM Option
If anyone else is allowed to pick up your pet, please give us their name(s) :
Please choose any a la carte special services you would like provided for your pet (per day cost) :

Stuffed Kong toy ($6)Video Updates ($9)Bedtime Snack ($5)Cuddle Session with a staff member ($10)Additional group play session ($15)
Or instead, save money with a package of services! (per day cost) :

Bells & Whistles Package : $24 (includes stuffed Kong treat, Video Update, Cuddle Session, Bedtime Snack)Full Steam Ahead Package : $16 (includes stuffed Kong treat, Video Update, Bedtime Snack)Streamlined Package : $9 (includes Kong treat and Bedtime Snack)
If any special services were selected above, what date would you like us to begin them?

MonthDayYear
Date
If any special services were selected above, how often would you like us to perform them?

Every dayEvery other dayEvery third dayOnce
If you would like multiple services on different days, please indicate which days you would like each service completed. If all services are to be completed on the same days, please leave blank:
Diet & Feeding
Duluth Dog Depot's house diet is Purina Gastrointestinal, a highly digestible low-fiber diet designed to be easy on your pet's stomach. If your pet is on a perscription diet or has special dietary considerations, please provide the food of your choice in labeled baggies. We cannot accept large bins/bags due to space. (Note:for allergy considerations, house diet contains chicken)
Who is providing food?*

Brought from homeDepot In-house Diet ($3/meal)
If brought from home, what brand is diet?
If you are boarding multiple pets, please choose your feeding preference below:

Feed with housemates (unmonitored)Feed with housemates (monitored)Separate to feed
Amount to feed per meal (standard 8oz measuring cup) :*
Amount to feed per meal (select measurement and container type)*
How many meals per day?*

MorningLunchEvening
Is it ok to supplement with our diet or treats if necessary?*

YesNo
Feel free to share with us any special instructions for feeding your pet :
Bathing & Grooming Services
Please select any of the following services you would like performed :

Nail Trim ONLY ($22)Gland Expression ONLY ($28)Standard Bath ($40-60) : Standard baths are completed with a kennel staff member and include nail trim, ear cleaning, gland expression, and brushing.Luxury Bath (Price Varies) : Luxury Baths are completed with a professional groomer and include nail trim and file, ear cleaning, gland expression, brush out, dematting & deshedding, and full body blow-out styling. Highly recommended for long-haired and curly coated breeds!Grooming/Hair Cut (Price Varies) : Grooming is completed with a professional groomer and includes bath, nail trim and file, ear cleaning, gland expression, demat and deshed, brush out, and hair cut with styling. Speak with receptionist for scheduling availability.
Medications & Medical Care
All medication administration is included in the cost of medical boarding. We can only accept prescriptions in the original bottle/packaging with prescription label.
Is your pet on any medications we will be administering?*

YesNo
Medication List
If your pet has special requirements or additional care needed (mobility help, medical treatments, disease monitoring, etc) please detail here how we can best serve their needs :
Medical & Emergency Information
Duluth Dog Depot has taken extensive measures in cleaning and sanitation to minimize the risk of contagious illnesses, including airborne viruses such as canine influenza or canine infectious respiratory disease ("kennel cough"). However, no amount of supervision or sanitation can guarantee a pet will not contract a contagious illness. And because day camp is a group play environment with close pet-to-pet interaction, injuries can sometimes occur during play. The pet owner understands and assumes all risks associated with their dog(s) coming into contact with other pets and people during his or her time at Duluth Dog Depot and will not hold the facility liable for illness or injury.
Does your pet have any medical conditions or had any medical treatments within the last 6 months?*

YesNo
If yes, please explain :
In case of illness, injury, or emergency, your pet will be treated at Duluth Animal Hospital. We will make every attempt to contact you for instructions. Please choose one of the following :*

Do ALL that Duluth Animal Hospital and Duluth Dog Depot deem necessary to maintain pet's health.Do not take extensive measures costing in excess of $500 (minimum requirement to cover initial serious emergency care).
By signing this agreement, I am acknowledging that i am the legal owner or authorized agent of the pet in question. I have read and agree to the individual care information and terms above.
Please feel free to add any specific information or requests regarding the care of your pet in case of illness, injury, or emergency :
Signature*

Powered by Jotform SignClear
Should be Empty:

Medical Boarding Contract

Diet & Feeding

Bathing & Grooming Services

Medications & Medical Care

Medical & Emergency Information