Lack of Fire Suppression & Overnight Staffing Agreement Form

Lack of Fire Suppression & Overnight Staffing Agreement Form
Foland Veterinary Services, PLLC (FVS), as is allowed by Texas law, is not equipped with an on-site fire suppression sprinkler system and does not employ on-site personnel...
- after 6:00pm on Monday through Thursday until 8:00am the following mornings
- after 5:00pm on Friday until 8:00am Saturday
- after roughly the average time of 9:30am Saturday until 6:30pm Saturday
- after roughly the average time of 7:30pm until 8:00am Sunday
- after roughly the average time of 9:30am Sunday until 6:30pm Sunday
- after roughly the average time of 7:30pm until 8:00am Monday...
On closed holidays and unexpected closures FVS does not employ on-site personnel. FVS will follow the same schedule listed above for Saturdays and Sundays to the best of our ability.

All pet(s) boarded or hospitalized at FVS will be left unattended during those times.
OWNER CONSENT AND RELEASE FOR DOG OR CAT TO BE LEFT UNATTENDED DURING BOARDING OR HOSPITALIZATION.
Date*

MonthDayYear
Client Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Patient Information
Name*
Species*
Breed*
Sex*
Color*
Current Weight*
Current Weight Unit*
Age*
Veterinarian: Paula Foland, DVM or Ron Foland, DVM

Clinic Phone Number: 817-598-0886
I, the undersigned client, hereby give my consent for my pet named above to be boarded or hospitalized at FVS on the following dates*
I acknowledge that have received and read FVS’s notice on its lack of fire suppression and overnight staffing. I understand and acknowledge that FVS is not equipped with an on-site fire suppression sprinkler system. I further understand and acknowledge that FVS is unstaffed between the hours specified in the notice and that my pet(s) will be left unattended during those times during their boarding or hospitalization stay.
By signing this consent form, | agree to release FVS, its owners, employees, and agents from any and all liabilities, claims or expenses arising from my pet’s boarding or hospitalization stay, including but not limited to injuries, illnesses, or death.

I have read and understood the statements outlined in the notice and in this consent form and release. | voluntarily consent to my pet(s) staying at FVS and acknowledge that | am solely responsible for any consequences that might arise during their stay.
Signature of Owner/Agent*

Clear
Date*

MonthDayYear
Should be Empty:

Lack of Fire Suppression & Overnight Staffing Agreement Form

OWNER CONSENT AND RELEASE FOR DOG OR CAT TO BE LEFT UNATTENDED DURING BOARDING OR HOSPITALIZATION.

Patient Information