First Name: (required)
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Last Name: (required)
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Pet's Name: (required)
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Arrival Date: (required)
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Departure Date: (required)
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Please list any additional veterinary services that you would like to have done:
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Please list feeding instructions for your pet (ex. 1 cup twice daily). If you provided your pet's own food be sure to also include the brand.
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Please list any medications and/or supplements that your pet is currently on. Be sure to include dosing instructions.
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I hereby authorize Carbon Valley Animal Hospital and Boarding kennels to board my pet. I am the owner and representative of my pet and agree to the following while my pet is boarding at CVAH.
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1.) In case of illness or injury, I give my consent to the Doctors and employees of CVAH to treat, prescribe for, or operate on my pet while being boarding.
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I understand that for such treatments I will be charged normal and ordinary fees, which will be due and payable at the time of release or pickup of my pet.
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In the rare and unfortunate event your pet dies in our care, the remains will be maintained for pick-up and/or further instructions. (required)
I Agree to the Above Statement
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2.) While I expect all reasonable precautions to prevent illness, injury, or escape of my pet, CVAH, it's owners, operators, or employees will not be held liable or responsible in any manner.
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Under any circumstances for the care, treatment or safe keeping of my pet, it is thoroughly understood that I assume all risks. (required)
I Agree to the Above Statement
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3.) I understand that the normal release or pick up of boarding animals is during normal business hours: 8AM-5:30PM Mon-Fri, and 9AM-12NOON on Saturday. (required)
I Agree to the Above Statement
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4.) I understand that if I provide pet food for my pet that I am to bring an airtight plastic box or container. Owner's name, Pet's name and feeding instructions MUST be on the container.
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I understand that if my pet requires medication to be given while boarding I am to provide it in the original bottle it was prescribed in
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I understand there are no additional charges for administering my pets food, however there may be an additional charge for any medications given. (required)
I Agree to the Above Statement
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5.) Should it become necessary to bathe my pet, I authorize CVAH to bathe but not groom my pet and will pay a normal or ordinary fee for this service. (required)
I Agree to the Above Statement
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6.) I will claim or pick up my pet by the pick up date I have stated, or I will, in advance, notify CVAH of my intention to board longer.
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Should my pet remain unclaimed, I give my permission to CVAH to act as representation of myself, and to take whatever action necessary to resolve this situation, including euthanasia. I will be responsible for accrued charges. (required)
I Agree to the Above Statement
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7.) I understand that ALL CHARGES ARE DUE AND PAYABLE IN FULL upon the release of my pet from CVAH boarding facility. (required)
I Agree to the Above Statement
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8.) All boarding animals must be current on all vaccines, at least ONE week prior to the boarding drop off date
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I have read the above and agree to these terms. (Please sign by typing your first and last name): (required)
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Date (mm/dd/yyyy): (required)
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Owner Contact Number: (required)
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Emergency Phone Number: (required)
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ALL BOARDING ANIMALS MUST BE CURRENT ON THEIR VACCINATIONS |
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