Boarding Release Form

Boarding Release Form

I, hereby consent and authorize my pet to be boarded at the Sandwich Veterinary Hospital. In the event of an illness or injury, the doctors will make an attempt to contact the person listed below at the phone number given. If contact cannot be made, the doctor will begin treatment as necessary and desirable in their professional judgement. I accept and assume total financial responsibility for any and all services rendered by the hospital, its staff or employees in the treatment of the above described animal and agree to pay the fees at the time of my pet's discharge. If my animal enters the hospital with fleas and/or ticks, they will be treated for fleas with a preventative and/or Capstar to kill fleas at my expense. If my animal is not claimed on or before the expected return date designated below, written notice will be mailed to the address on file to remove the animal(s). Five days after such written notice, the animal(s) will be considered abandoned.
Owner's Name *

First Name Last Name
Pet's Name *
Canine Feline
Owner Contact Info
Contact Person *

First Name Last Name
Contact Phone Number *

Area Code Phone Number
Contact Phone Number Type
Alternate Phone Number

Area Code Phone Number
Contact Phone Number Type
Email
example@example.com
Arrival Date *

Month Day Year
First day of boarding
Return Date *

Month Day Year
Day checking out
Signature *

Clear
Feeding

You may bring your pet's own diet. If you do not bring your pet's diet we will feed Hill's Science Diet Sensitive Skin and Stomach.
Are you bringing your pet's food?

Yes No
Name of Food(s)
Amount of DRY fed
Amount of CANNED fed
Number of times fed per day
Bathing/Nail Trim

Please check the appropriate box for the optional services you would like
Please select from below

Comp. bath after 3+ nights of boarding (dogs only) Bath after boarding (dogs only) $20 Bath and Nail Trim (dogs only) $30 Nail Trim $10 None
Toys/Bedding

Upon request we will provide your pet with the following options, they all get extra pets and love regardless! We request that you do not bring these items from home, we don't want to lose your pet's favorite blanket!
My pet would like:

A Kong rubber toy filled with dog safe "cheese" A ball Blankets
By checking this box you confirm that it is ok to leave your pet with a blanket unsupervised, please do not check yes if your pet has any history or thoughts of chewing on these, that surgery is expensive!

Yes, it is ok to give my pet a blanket.
Medical Information
Is your pet on any medication that will need to be administered while boarding? (Med administration is $3 per day)

Yes No
Please list the medications below and include the directions (how much and how often to give) and the last time the medication was given
Should be Empty:

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