Boarding Release Form

Please Make Sure to Check the Submit Button When Completing the Form Online.

To keep all our patients protected, proof of current vaccinations including the flu vaccine must be presented when pets are being admitted. If proof is not provided, the required vaccination will be given and charged to your invoice

Date

Client ID#

Name*

Address*

Phone*

Emergency Contact*

Phone*

Email*

Pet Namel*

Species*

Breed (If Known)

Estimated Age*

Sex*

Color*

Drop off Date*

Drop off Time*

Pick-up Date*

Pick-up Time

Person picking up pet if other than owner

Bath*

Medication*

Scheduled Grooming*

Nail Trim Only*

Personal Items Left (Check all that apply)

Feeding*

Quantity Each Feed*

Preferred Diet*

Extra Play Time ($6.00 each)

Puppy Pops (Frozen Dog Treats)($1.00 each)

Special instructions/Other requirements-include detailed medication, feeding, instructions, and anything you wish the doctor to check.

VACCINATION/EXTERNAL PARASITE POLICY

To ensure the protection of all the pets under our care, vaccinations must be current.

MEDICAL ILLNESS POLICY

One of the advantages of boarding your pet(s) at a veterinary hospital is that medical attention is readily available. If your pet becomes ill, we will call you the above emergency number(s) regarding your pet's symptoms and treatment options.


Please perform whatever services the doctor deems necessary for the best care for my pet until someone can be reached by telephone. This Includes only non-elective treatments and necessary diagnostic testing.

I authorize up to:*

Do not administer and medical treatment until specific authorization is given. Please type N/A if this is not your choice.*

We are not liable for any lost items such as toys, bedding, blankets, etc. I have read and understand this agreement. I fully intend to pick up my pet(s) at the above specified date and pay in full at the time. If circumstances change, I will notify Animal Hospital of Whitfield County of a new pick-up date.*

Date*

none 8:00am - 5:00pm 8:00am - 7:00pm 8:00am - 5:00pm 8:00am - 6:00pm 8:00am - 5:00pm Closed Closed veterinarian # # # https://goo.gl/maps/bJAtJRteZxkDbn118 https://admin.roya.com/sites/Site-aed916ea-d694-49f3-a7ef-98675bd9dd5b/ 1176 Aloha St. Unit 100
Castle Rock, CO 80104 720-464-3525 720-790-5095 720-782-6144 https://apps.apple.com/us/app/petdesk/id631377773 https://play.google.com/store/apps/details?id=com.locai.petpartner&hl=en&gl=US