Animal Doctor Blue Hills Your Other Family Doctor Boarding Agreement Boarding Agreement Owner's Name: * Owner's Phone Number: * Today's Date: * Pick-Up Date: * Pick-Up Time (PLEASE SIGNIFY AM OR PM): * Emergency Contact: * Emergency Contact Phone Number: * Pet(s) Boarding (PLEASE LIST ALL PETS BOARDING DURING THIS TIME): * Would you like your pet(s) to have a bath before going home? * Yes No Is your pet on any medications? Please provide instructions below. * Yes No Medicine instructions: * Please provide feeding instructions for your pet(s). Include the type of food, how often, and how much to feed. * What belongings will your pet have: * VACCINATION POLICY: If vaccinations are not current or if proof of vaccinations is not provided, I give permission for Animal Doctor Blue Hills to update vaccinations in accordance with the above policy. * By checking this box, you acknowledge that you have read and understand the vaccination policy. I understand that my pet must be up to date on his/her flea/tick prevention during his/her stay. In addition, if any fleas or ticks are observed on my pet(s), I understand that they will be treated with Frontline at my expense. * By checking this box, you acknowledge that you have read and understand this policy. If boarding more than one pet, please select if you want them housed together. Select N/A if this does not apply to you. * House both pets together Keep pets separate Does not apply MEDICAL ILLNESS POLICY: One of the advantages to boarding your pet at Animal Doctor Blue Hills is that veterinary attention is readily available should the need arise. If your pet(s) become ill, we will call the emergency number(s) given above regarding your pet's symptoms, treatment options, and estimates of additional costs. However, if no one can be reached, one of the three actions listed below will be taken should your pet(s) require treatment to relieve immediate discomfort or to resolve an important medical condition. CHOOSE ONE ONLY. * Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached. This includes only non-elective treatments and necessary diagnostics. I authorize up to an allocated amount (please specify below) in medical care my pet(s) until someone can be reached. Do not administer any medical treatment until specific authorization is given. If you opted to receive care up to an allocated amount, please specify that amount below. If not, skip this question. I have read and understand this agreement. I understand that I am responsible for all charges/costs included in both policies stated above. I fully intend to pick-up my pet(s) on the date specified above. If circumstances change, I will notify Animal Doctor Blue Hills of the new pick-up date and time. I also understand that payment is due when the animals are picked-up, unless other arrangements have been approved by the doctor. The staff at Animal Doctor Blue Hills will do everything possible to keep your pet happy and healthy, however, please be aware of the risks in boarding your pet(s) at any facility. These risks include, but are not limited to, injuries, infections, stress, diarrhea, or vomiting. PLEASE TYPE YOUR NAME BELOW TO SIGN THIS AGREEMENT. * If you are human, leave this field blank. Submit
