Jones Bridge Animal Hospital Lodging Agreement

We are very pleased that you have entrusted us with the care of your pet(s) while you are away. The following information will help ensure everything is in order for his/her stay.

Full name of pet (If you have multiple pets, please fill out a separate form). *

Pet Name Client Last Name

Phone number in case we need to reach you: *

- Area Code Phone Number

PROOF OF VACCINATIONS: All pets must be current on vaccinations to enter the lodging facility. This ensures your pet’s protection as well as the safety of our other boarders. The required vaccinations include: DOGS: DA2P or DHLPP (Canine Distemper) yearly or every 3 years, Bordatella (kennel cough) yearly, Rabies Vaccine yearly or every 3 years, Fecal Exam. CATS: DRCP (Feline Distemper) yearly, Rabies Vaccine yearly. If vaccinations have been administered elsewhere, please provide documentation to that effect.

PERSONAL ITEMS: Clean bedding will be provided for all pets lodging with us. We understand the desire to leave personal bedding with your pet, but due to cleanliness issues, we prefer to use our own bedding unless special needs of a pet’s condition require other bedding to be used. Any personal items left with pets must be labeled very plainly with permanent marker. JONES BRIDGE ANIMAL HOSPITAL IS NOT RESPONSIBLE FOR DAMAGED OR LOST PERSONAL ITEMS LEFT WITH PETS. Your pets lodging area is cleaned thoroughly every day (or more often as needed) and all bedding changed and washed.

SPECIAL FOOD: Unless personal food is brought, your pet will be fed Royal Canin Gastrointestinal premium dog food according to his/her age/size/etc. Cats will receive Science Diet Optimal Care premium cat food. We will be happy to feed any food that you may provide for your pet. There is no additional charge for this service. Please individually bag each meal and label food with pet’s name and feeding instructions.

MEDICATIONS: Any medications your pet may need will be given by our support staff. ALL MEDICATIONS MUST BE LABELED PROPERLY AND IN THEIR ORGINIAL CONTAINERS. Due to AAHA regulations we are unable to provide unauthorized or unidentified medications. This is to better service your pet’s needs. Diabetic care will incur a separate charge.

BATHING/TOENAIL TRIM: It is recommended that all dogs receive a bath before going home. Pet hair attracts odor easily and even the cleanest dogs may pick up odors. The charge for bathing is additional and will depend upon the size of the pet. If a bath is requested, your pet will be available for pick up after 4pm. If you are picking your pet up in the morning please let us know at time of drop off; the bath may be done on the previous day.

You have selected Suite Lodging for your pet's reservation.

Suite Lodging: Dogs will lodge in premium suites (some with window views) and will automatically participate in TLC. Medications, if needed, will be given at no additional cost.

The purpose of Group Play offered in our TLC Package is to provide a safe, fun and stimulating social environment for our lodging dogs. Dogs will be able to exercise during action packed sessions where they will learn social skills and have personal interaction with trained team members as well as other dogs. This type of play will also provide an often much-needed outlet for high-energy dogs. If your dog doesn’t socialize well with other dogs, one-on-one time will be offered instead with all of the above mentioned benefits. Activities will vary, but rest assured that your dog will be under constant supervision by our trained staff. We understand that not all dogs play the same, so dogs will be let out in groups no larger than 8; size, breed, age and demeanor will all be determining factors when placing them within the appropriate group. There are additional fees associated with this service.

Jones Bridge Animal Hospital K9 Group Play Release Form

I hereby certify that my dog is in good health and has not been exposed to any known communicable condition in the last 30 days, nor is exhibiting any upper respiratory symptoms (i.e. nasal discharge, coughing, fever, etc).

I further certify that I have fully disclosed any situations where my dog may have shown any type of aggressive behavior.

My dog is currently on heartworm and flea prevention.

I understand that participation in group play is not without risk. Dogs are not always predictable and the unexpected may occur. If my dog does show aggressive tendencies and does not socialize well with other dogs, I understand that no more group play will be allowed. I hereby waive and release Jones Bridge Animal Hospital and it’s staff from any and all claims while on the premises. I release Jones Bridge Animal Hospital of any liability of any kind whatsoever arising from my dog’s attendance and participation in group play.

I further understand and agree that any problems which may develop with my dog will be treated as deemed best by the veterinarians and staff at Jones Bridge Animal Hospital and that I assume full financial responsibility for any expenses involved.

I have read and agree to all the terms listed above. *

Reservation Start Date *

Date

Reservation End Date *

Date

Feeding Instructions: *

Did you bring your own food? *

Yes No

Has your pet been fed today? *

No Yes, last meal was in the A.M. Yes, last meal was in the P.M.

Medication List: *

Please list the medications and the quantity/frequency if applicable

Does your pet require an examination and/or vaccinations while lodging? If yes, please specify below: *

Which of the following services would you like to receive on exit: *

Bath Nail Trim Anal Gland Expression None of the Above

Does your pet require special medical services while lodging? If yes, please specify below:

A consultation may be required at the time of drop off. Additional fees may apply.

Jones Bridge Animal Hospital Lodging Release Form

I hereby authorize Jones Bridge Animal Hospital, its employees, representatives or agents, to receive, care for, vaccinate, prescribe for, medicate, test, and/or bathe my animal as they deem necessary for the health, safety, or well-being of my pet.

I understand that all reasonable precautions against injury, escape or death of my pet will be used. In the absence of gross negligence, I thoroughly understand that I assume certain risks and will not hold Jones Bridge Animal Hospital, its employees, representatives or agents liable or responsible in any manner or circumstances for these risks.

Lastly, I understand that all responsibility for payment for services provided in this office for my pet is mine, due and payable at the time services are rendered.

I have read and agree to all the terms listed above. *

Electronic Signature: *

Please type your name above

Date *

Date

This space is for internal use

Weight on entry: