Client Information Owner Name(Required)
First
Last
Address(Required)
What is the best way to reach you while your pet is staying with us?(Required) Owner Name(Required)
First
Last
Pet Information ONLY ONE PET PER AGREEMENT FORM
Please provide all dry food in indiviudal ziploc bags labeled with your pets name, the date food is provided for, and AM, MIDDAY or PM as required for the entirety that your is staying with us. Please label all canned food with your pets name, frequency and amount to feed on the front of the can.
If you forget your pets food, we can provide you with a small bag of prescription bland house diet for an additional charge of the cost of the diet (usually $35-50 per 6-8pound bag).
Note: We are unable to take in large bags of pet food - thank you for your cooperation!
I understand all medications must be brought in their original labeled bottles and/or packaging.(Required)
Initial Here
Drop Off & Pick Up Which date(s) are you looking to board?(Required)
Drop Off Time(Required) MUST be between 3pm-5pm
Pick Up Time(Required) MUST be between 8am-10:30am
I understand if my pet is not picked up by 10am or is dropped off before 3pm, an additional day of boarding may be charged.(Required)
Initial Here
I understand if my pet displays unpredictable and/or aggressive behavior towards any Animal Care Coordinators, I am required to make arrangements for my pet to be picked up immediately.(Required)
Initial Here
By signing your name, you agree to the terms below:
Consent(Required) I agree to the below financial policy
Payment is due at time of service. Forms of payment accepted include cash, all major credit cards, Care Credit, and Scratchpay. Checks are not accepted.
Consent(Required) I agree to the below policy
I, the undersigned, certify that I am 18 years of age or older and I am the legal owner (or authorized agent of the owner) of the patient listed above. I agree to assume financial responsibility for all charges incurred and agree to pay such charges at the time of services rendered. I also understand that personal checks are not accepted. I am responsible for all interest and collection fees on any unpaid balance, as well as reasonable attorney fees and court costs associated with collection of unpaid balances. I acknowledge that the above information is true and accurate to the best of my knowledge.
Authorization Signature(Required)
First Name
Last Name
Email Consent I agree to receive email communications.
I agree to receive marketing offers and updates via your preferred/primary email. You'll still receive services and account related emails if you do not check the box.
SMS Consent I agree to receive SMS communications.
I agree to receive recurring automated messages about pet care, appointment reminders, marketing communications, and offers to the mobile number provided. Your consent is not required, and you may opt out at any time by replying STOP. Msg & data rates may apply. Message frequency may vary.
