"*" indicates required fields Please complete the following form allowing American Veterinary Hospital to board your pet. We ask that you read the form in its entirety and acknowledge each statement. If you have questions or concerns regarding this form please contact our practice directly. Vaccination Policy To ensure the health and safety of all pets under our care from contagious diseases, the following vaccines/services are required for all borders staying at the practice. If you have had these services performed elsewhere, proof will need to be provided prior to your drop off date. Please NOTE: In order for vaccinations to be effective they MUST be done 3 weeks prior to boarding Canine Requirements: Rabies Distemper (DAPP) Leptospirosis (Lepto) Bordetella (kennel cough) Fecal Test (Negative result within 1 month) Current Flea & Tick Prevention Feline Requirements: Rabies Distemper (FVRCP) Fecal Test (Negative within 1 month) Current Flea and Tick Prevention Boarding Fees: Canine $25 per night/per dog Feline $20 per night/per dog Unaltered pets over 6 months - Additional $4.00 per night/per pet Medication Administration - $4.00 per night/per pet Insulin Administration - $10.00 per night/per pet Late Pick Up Fee - Additional $25.00 per night/per pet Medical Care while boarding - determined cases to case, as needed Please Note: If you’re picking up your pet(s) before 12pm the day of the scheduled pickup date no charges are incurred for that day of boarding. Boarding Pick Up & Drop Off Times; Monday - Friday 9am - 5pm Saturday - 10am - 12pm Sunday - No services Medical Illness Policy In the event your pet becomes ill, we will contact you via the emergency contact provided.Consent* I understand that in the event no one can be reached and no special instructions have been indicated, I am authorizing the hospital to perform the appropriate services as deemed necessary by the doctor until the contact is available. At which time a treatment plan will be discussed and decided upon.Late Fee/ Abandonment PolicyConsent* I understand that if I do not notify the hospital of any changes to pet(s) reservation, a late fee of $25 per day/ per pet will be charged in addition to regular boarding fees.Consent* I understand that if I have no contact with the hospital and the pet(s) is not picked up within 3 days of the scheduled pick-up date, a written notice will be sent to the address on file. 5 days after the written notice is sent, the pet(s) is considered abandoned and may be dealt with as the hospital deems appropriate. All boarding and late fees incurred are still my responsibility and need to be paid in full.Consent* I understand that there is NO staff on the premises after business hours. Employees do come in to care for pets on weekends and holidays, however do NOT spend the whole day at the hospital.Date of Drop Off* MM slash DD slash YYYY Date of Pick Up* MM slash DD slash YYYY Signature*Date* MM slash DD slash YYYY Emergency Contact Name Emergency Contact #2nd Emergency Contact Name 2nd Emergency Contact #PhoneThis field is for validation purposes and should be left unchanged.
