Boarding Agreement Form

Client Name

Pet Name

Where can we reach you while you are away?

Telephone Number

Cell Phone Number

Emergency Contact Name/Number

Pick-up date and time

Staff Must Verify Prior to Admission:
Staff member initials

Vaccination & Exam Due Dates
​​​​​​​**MUST be current on all vaccines before boarding**


Canned / Dry

Once/Twice Daily

Medications: Please note that there will be a fee of $3.00 per day to administer any medications

Given Today?

Special Instructions

While your pet is here, would you like any additional services?

Reasonable precautions will be taken against injury, escape, or death of this pet. The clinic and staff will not be held liable for problems that develop provided reasonable care and precautions are followed. I understand that any problem that develops with my pet will be treated as deemed best by the staff veterinarians and I assume full responsibility for the treatment expense involved as well as all fees associated with the boarding. (We will attempt to contact you prior to any un-expected treatment). I understand that if fleas are found on my pet, a flea prevention product may be applied, at my expense, to protect the health of my pet and other pets at the clinic.

Signature of owner or responsible party:


Pajibar00 none 8:00 am - 6:00 pm 8:00 am - 6:00 pm 8:00 am - 6:00 pm 8:00 am - 6:00 pm 8:00 am - 6:00 pm Closed Closed veterinarian # # #