Direct Release Request - Kauai North Shore Animal Clinic

Kauai North Shore Animal Clinic
Direct Release Flight Change OR Cancellation- Kauai North Shore Animal Clinic

For Direct Release into Lihue Airport Only
Today's Date*

MonthDayYear
Date
Owner full name*
Owner phone number*
Owner e-mail*
example@example.com
Please indicate if this is a RESCHEDULE or a CANCELLATION*

Please check this box if you are RESCHEDULING your flightPlease check this box and type CANCELLATION in the box below if you are cancelling your Direct Release
Please indicate the PREVIOUS date of arrival.*

MonthDayYear
Date
Refund option*

Leave the booking price as a credit on your account for future use either in the clinic or for a Direct Release in the future. There will be a rebooking fee of $50 should you choose to re-book in the future. (subject to refund policy)Please issue a refund to the credit card that was used to book the direct release (subject to refund policy, no refunds if cancellation is less than 48 hours prior to arrival)
New date of arrival*

MonthDayYear
Date
Time of arrival*
I understand Direct Releases outside of regular Direct Release hours (M-F 8:00am-5:00pm) will be subject to after hours arrival charge.*

Check box to confirm
Airline AND flight number (flight number only will not be sufficient)*
*If flying private, please provide the aircraft, state tail # or name of carrier service. Also provide the name of the FBO (Fixed Based Operator), either Signature Aviation or Atlantic Aviation at Lihue Airport. Requests cannot be processed without this information*
**If any of the above information is incomplete or microchip number is incorrect, the confirmation will be returned to you for correction.
Pet #1 Name*
Pet #1 Microchip*
PLEASE double check that this number is correct!
Pet #1 Species*
Pet #1 Sex*
Pet #1 Color*
Pet #1 Age*
Pet #1 Breed*
Is Pet # 1 travelling:*

In the cabin with you.Checked baggage (you are on the same flight and you are checking your pet in at the airline ticket counter)Cargo (your pet is oversized or you are not travelling on the same flight - you are checking your pet in at the airline's cargo facility)
Add 2nd Pet*

YesNo
Pet # 2 Name*
Pet #2 Microchip*
Pet # 2 Species*
Pet # 2 Sex*
Pet #2 Color*
Pet # 2 Age*
Pet # 2 Breed*
Is Pet # 2 travelling:*

In the cabin with you.Checked baggage (you are on the same flight and you are checking your pet in at the airline ticket counter)Cargo (your pet is oversized or you are not travelling on the same flight - you are checking your pet in at the airline's cargo facility)
Add 3rd Pet

YesNo
Pet # 3 Name*
Pet # 3 Microchip*
Pet # 3 Species*
Pet # 3 Sex*
Pet # 3 Color*
Pet # 3 Age*
Pet # 3 Breed*
Is Pet # 3 travelling:*

In the cabin with you.Checked baggage (you are on the same flight and you are checking your pet in at the airline ticket counter)Cargo (your pet is oversized or you are not travelling on the same flight - you are checking your pet in at the airline's cargo facility)
Add 4th Pet*

YesNo
Pet # 4 Name*
Pet # 4 Microchip*
Pet # 4 Species*
Pet # 4 Sex*
Pet # 4 Color*
Pet # 4 Age*
Pet # 4 Breed*
Is Pet # 4 travelling:*

In the cabin with you.Checked baggage (you are on the same flight and you are checking your pet in at the airline ticket counter)Cargo (your pet is oversized or you are not travelling on the same flight - you are checking your pet in at the airline's cargo facility)
I have confirmed the above flight information is correct. Flight changes are subject to $50 flight change fee.*

Check box to confirm
I confirm this flight originates from the mainland and Lihue is my pet's first port of entry into the state of Hawaii.*

Check box to confirm
I understand that if I fail to update KNSAC of travel changes or do not arrive as scheduled I will be subject to additional re-booking fees.*

Check box to confirm
I agree it is solely my responsibility to confirm all requirements, set forth by the Animal Quarantine Station, have been met to allow my pet to be released on Kauai by Kauai North Shore Animal Clinic.

By signing below I agree the information I have provided above is correct. I understand all requirements for entry and associated fees and policies.
I understand that by cancelling my Direct Release booking my pet will not be eligible for a Direct Release on Kaua'i until I have re-booked with the Animal Quarantine Station and Kaua'i North Shore Animal Clinic.
Signature*

Clear
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Kauai North Shore Animal Clinic

Direct Release Flight Change OR Cancellation- Kauai North Shore Animal Clinic