Pet's Name
Owner/Agent's Name
Phone number where you can be reached
Requested Treatments/Services (additional charges will be added to your bill): (Example: exam, vaccines, bath, nail trim, anal gland expression, application of flea control product
I understand that I will be charged for the day of check-in, regardless of time, and that the check-out time is 12:00pm noon (I will not be responsible for that day if picked up before then, and will only be charged if picked up after).
Yes
I understand that if any vaccines are due or no proof of vaccines AT THE TIME OF CHECK IN, according to The Family Pet policy, they will be administered and I will be responsible for all charges.
Yes
I understand that should fleas be found on my pet, hospital staff will administer flea treatment (either topical flea medication or oral doses of Capstar), and that I will be responsible for the charges.
Yes
I understand that additional charges will be added for handling if my pet creates unsanitary boarding conditions or is not easily manageable. I also understand that administering medication to my pet will necessitate an additional per-day fee.
Yes
I understand that my pet's health is a priority and if I am not able to be contacted for authorization, basic or emergent medical care will be provided for my pet at the doctor's discretion, and that I will be responsible for the charges.
Yes
I understand that all charges will be due at the time of check-out.
Yes
I understand that in the event of a fire or a natural disaster, The Family Pet will not be held resposible for any injury or loss of life sustained
Yes
I understand that if I bring any belongings to be left with my pet, there is a chance they will be lost and/or damaged. The Family Pet is not responsible for any lost or damaged items.
Yes
Pet's Belongings:
Cat Quality Time - Please check the days that your cat would like some extra 1 on 1 time.. Playtime is $10.00 per day, by checking these days you acknowledge said charge.
Monday
Tuesday
Wednesday
Thursday
Friday
Would it be okay if we took a picture of your pet and put it on social media?
Yes
No
Name of person picking up pet. ***If I have made arrangements for another person to pick up my animal from boarding, I understand that I need to prepay or put a credit card on file when my pet is admitted. ***
Phone of person picking up pet
In case of a life threatening injury/illness:
Yes, please administer CPR to my pet.
No, please DO NOT administer CPR to my pet.
Emergency Contact Name
Emergency Contact Phone Number
If available, please attach pet's vaccination records.
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