Boarding Registration and Release Authorization |
| Name: |
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Telephone #: |
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| Pets Name: |
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Vaccines up to date?: |
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| Size of Pet : |
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Please provide Name, Address and Phone Number of last known veterinarian
(If other than Animal Hospital of Dunedin): |
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| Check In Date : |
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Pick Up Date : |
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| If you are boarding your pet with us, we do require confirmationthat these particular vaccinations are current: |
| For Canine Companion(s), the required vaccinations are: |
Distemper/Parvo, Rabies and Bordetella (Kennel Cough). |
| For Feline Companion(s), the required vaccinations are: |
Distemper and Rabies. |
| **If we discover that that any of these vaccines are outdated we will administer those that are required at the owner's expense. ** |
| Is your pet on a precription diet? |
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Name of food : |
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| What kind of food does your pet eat? |
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| Did you bring this food with you? |
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| Is your pet on any medication? |
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| If yes, what medication(s) does your pet take? |
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| Did you bring these medications? |
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| When was the last time you applied flea or flea/flea and tick prevention? |
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| What was the product used? |
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| Are there any special concerns regarding the care of your pet? |
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Would you like your pet to be bathed?
*There is an additional fee for the bath* |
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| What time will you be picking up your pet? |
AM OR PM |
| All pets left for boarding MUST be current on all required vaccinations and free of fleas and ticks, or they must be treated upon admission at the owners' expense! If any medications become necessary in order to treat or handle your pet, the Animal Hospital of Dunedin is authorized to administer such medication. The Animal Hospital of Dunedin will use all reasonable precautions against escape, injury, or death of the pet. If the pet should become ill during this stay, the Animal Hospital of Dunedin will not be held liable, provided that reasonable care and all precautions had been taken. I understand that boarding can be stressful for some pets and may predispose them to medical conditions not normally encountered in the home setting. |
| **Due to the fact that we will be frequently cleansing the area in which your pet stays, we suggest that you do not leave any of the following items as we can not guarantee their return: toys, blankets, beds, bones, leashes, collars, food dishes etc.** |
| I authorize the staff veterinarians of the Animal Hospital of Dunedin to treat my pet as needed and I ASSUME FULL RESPONSIBILITY FOR EXPENSES INCURRED! |
| Emergency Contact Name : |
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Phone Number : |
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| Signature of Owner of Responsible Party (Type Full Name) |
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