Westlake Boarding Release Form

Boarding Dates

Start - End Date

Owner's Name

First NameLast Name

Owner's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Owner's Phone

Please enter a valid phone number.Format: (000) 000-0000.

Emergency Name and Phone

Pet's Name

Microchip #

Age

Species

Breed

Gender

Brand and type of food you will be supplying for your pets stay:

How much and how many times a day should we feed your pet?

Does your pet have food allergies?

If yes please list.

Is your pet currently on regular flea and tick preventative?

If you answered 'No', oral preventative will be given upon entrance and exit at the owner's expense to prevent flea infestation.

Please list all medications/supplements your pet is currently taking:

Bath (additional charge)

Medical Treatments

Personal Belongings

Requirements for Boarding
1. All animals must be current on all vaccines.

2. All animals will be treated at owner's expense for any external parasites (ex. ticks, fleas, etc.).

3. WLAH has my permission to do whatever is necessary should an emergency arise.

4. If a tranquilizer is necessary for treatment or handling, WLAH has my permission to administer such medication.

5. WLAH is not responsible for the loss or damage of any personal belongings such as bedding or toys.

6. Canine boarders may be picked up from 7:00am-6:00pm Monday through Friday and from 10:00am-12:00pm on Saturday.

Feline boarders may be picked up from 7:00am-6:00pm at the hospital.
*Pets picked up after 2:00pm will be charged a late pick up fee of $13.
*Pets may not be picked up on Sundays or Holidays.
*Pets receiving medical treatment may be picked up after 2:00pm without being charged.

7. A credit card number or another form of payment is required as a deposit. A payment is required after 14 days and every 14 days thereafter. Lack of payment as specified may be considered abandonment of your pet(s).

In the event that your pet develops diarrhea while boarding, I authorize Westlake Animal Hospital to start an anti-diarrheal probiotic supplement and diet if the doctor deems it appropriate and is unable to reach me. The cost will average between $15.50 - $50 depending on weight.

In the event that your pet becomes stressed or anxious during their stay, I authorize Westlake Animal Hospital to start oral anti anxiety meds if approved by a veterinarian

I AUTHORIZE WESTLAKE ANIMAL HOSPITAL TO PHOTOGRAPH AND POST PHOTOS OF MY PET(S) ON SOCIAL MEDIA

Texas Law HB 2063 Acknowledgement - I understand that this facility, Westlake Animal Hospital, IS NOT staffed 24 hours a day and there are times that mypet will be left unattended without an employee present. I also acknowledge that this facility IS NOT equipped with afire suppression sprinkler system.

Boarding Consent Acknowledgement
I have read the boarding requirements outlined on this consent form and understand the practice’s policies. I certify I am the owner or agent responsible for the animal described above, that I am over 18 years of age, and I have the authority to give lawful consent to the terms and conditions contained in this form.

Printed name of Owner or Responsible Agent:

Phone number where Owner/Agent can be reached:

Date:

The vast majority of procedures and hospitalizations have good outcomes and proceed according to plan. In the unexpected event of a sudden decline of your pet’s health, we want to be prepared to respond in a manner that meets your wishes and fulfills your emotional and financial needs.

I have read and understand these boarding requirements and policies.

Today's Date

Date

Owner Signature