Feline Boarding

Feline Boarding Admission Form

Client Name:

Phone Number(s):

Pet Name(s):

Drop off Date:

Pick up Date:

Name of Emergency Contact:

Emergency Phone Number:

Email Address

Person who will pick up the pet
MeSomeone else

If someone else is picking up your pet

Name:

Contact Phone Number:

*We will not release your pet to anyone without authorization.
Please inform them we may want to see ID.

Is your pet on medication? (Please check the box)
YesNo

List each medication with instructions ($1 charge for medication
administration):

Please note: All medications need to be brought in their original packaging or
prescription bottle. We will not accept medications that are not labeled properly.

Directions for feeding:

Unless food is provided, all cats are fed Science Diet Adult dry kibble according to their weight. Please keep in mind that your pet’s eating habits may differ while boarding due to decreased activity, stress, etc.

Please feed my pet with your foodI have provided my pets food

Feeding directions:

Vaccination

For your pet’s protection, we require the following current vaccinations for
boarding at our facility: Feline Distemper(yearly)($34), Rabies(yearly)($40),
and a negative fecal parasite exam($28) within the past 6 months. For
maximum effectiveness, vaccines should be administered at least 7 days
prior to boarding. If your pet has not been vaccinated by us, you are
responsible for providing documentation from a licensed veterinarian of
your pet’s vaccinations. If you cannot provide this documentation, we will
vaccinate your pet.

My pet has been vaccinated at:
Summit Chase Animal Hospitalat another animal clinic and I have provided documentation

Any other problem

Please list any problems or concerns you would like checked by a doctor
while your pet is here($68.00 exam fee applies):

Blankets and towels

We NO longer accept personal blankets/towels. We will provide your pet
with blankets or towels upon request, however, if your pet chews/ingests
them we will remove them and will not be held responsible for any medical
issues that could arise.

Would you like your pet to have a blanket/towel?
YesNo

We also cannot leave toys in pet’s kennels in case of possible ingestion.

We also offer grooming services by pre-scheduled appointments and upon
availability. If your pet is scheduled for grooming, please leave detailed
instructions for the groomer here:

If the staff notices any other issues with your pet that require a Doctor’s
attention, how would you like us to proceed?

Please treat my pet as required; you need not call me before treating.Perform only emergency and supportive care before calling me. Notify me for permission to begin further treatment/diagnostics.Do NOT perform any diagnostics and/or treatment until I am notified and consent for you to evaluate and treat as recommended.

Charges for boarding begin the day of arrival and will include the day your
pet is picked up, unless you pick up before 10:00am.

Pets can only be picked up during regular business hours:
Monday-Friday 7:30am-5:30pm; Saturday 8:00am-12:00pm

All pets will be inspected for external parasites (fleas,ticks, etc.) and will be
treated if necessary at the owners’ expense.

Date and type of last flea treatment

If the pet is found to be aggressive and dangerous to the staff, other animals
or itself, additional charges may accrue if special arrangements have to be
made to handle the situation.

All reasonable precautions will be used to prevent injury and escape of your
pet. Summit Chase Animal Hospital is not responsible for the actions of the
pet that may cause injury and escape.

OWNER RELEASE: I understand Summit Chase Animal Hospital CANNOT guarantee the health of my pet. I understand and will not hold Summit Chase Animal Hospital responsible for conditions that are unavoidable in boarding kennels, such as but not limited to weight loss, hair loss, upper respiratory infections, bronchitis, and diarrhea. I am aware that staff is not present after normal business hours and that my pet will be unsupervised during that time.

I understand that in the event of my pet’s illness, the staff will immediately attempt to contact me or my agent to discuss the problem and treatment options. If they are not able to contact me immediately they are authorized to initiate appropriate treatment in a life-threatening situation until me or my agent can be reached.

I understand that I am financially responsible for any medical treatment
performed on my pet while at Summit Chase Animal Hospital.

I agreeI disagree

I understand that by filling out this form it is not a request for a reservation. I will call the animal hospital to verify availability and schedule a reservation for my pet.

Feline Boarding

Feline Boarding Admission Form

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