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Premier Pet Resort & Day Spa

By Suzanne Robertson,2014-06-28 10:19
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Premier Pet Resort & Day Spa ...

    Premier Pet Resort & Day Spa

    Boarding Release Form

Owner’s Name: ______________________________________

Emergency Contact: ________________________ Email: _______________________

Check In Date: _________ Time: ________ Check Out Date: ________ Time: __________

    ***Sunday pick up time is between 3:00-5:00pm. There is an additional service charge

    of $______ per pet if you pick up on a Sunday. Initial: _______

     stnd1 Pet’s Name: ________________ Dog / Cat 2 Pet’s Name: _________________ Dog / Cat

     rdth3 Pet’s Name: ________________ Dog / Cat 4 Pet’s Name: _________________ Dog / Cat

     thth5 Pet’s Name: ________________ Dog / Cat 6 Pet’s Name: _________________ Dog / Cat

Vaccinations Current / Due: ____________________________________ Initial: __________

    (Vaccines must be done prior to coming in)

    Doctor Treatments Needed: ______________________________________________________

Medication/Food Refills: Y / N If yes: _____________________________________________

    Feeding Instructions: Kennel or Own Food Brand Name: ___________ Amount: ______

How often do you feed? 1X / 2X / Free Do we need to entice with wet food? Y / N

Medications: Y / N Have medications been giving today? Y / N Which Dose? AM / PM / Both

    *There is a $0.65 treatment fee, per medication dosage given per day. Initial: _____

     st1 Medication: _______________________ 1 time a day/ 2 Times a day / 3 times a day /

    BID / TID / AS NEEDED nd 2Medication: _______________________ SID / BID / TID / AS NEEDED rd 3Medication: _______________________ SID / BID / TID / AS NEEDED th4 Medication: _______________________ SID / BID / TID / AS NEEDED

Medication dosage changed per owner? Y / N Initial: ________

Is there Luggage that is being left with patient? Y / N

     st1 Luggage: _____________________________ nd2 Luggage: _____________________________ rd3 Luggage: _____________________________ th4 Luggage: _____________________________ th5 Luggage: _____________________________ th6 Luggage: _____________________________

Playtime: Y / N Playtime Package Deal? Y / N Package Name: __________________

Bath w/boarding: Y / N Groom w/Lisa: Y / N Scheduled Date: _________

Special grooming instructions: ______________________________________________

Would you like Sugar Cookie applied to your pet at Check out: Y / N

*In the event that your pet (s) has an adverse reaction or a staff member observes

    anything abnormal during their stay with us, please allow our Doctors to provide the

    necessary care for your pet (s).

**I authorize Premier Animal Hospital to do what is in the best interest of my pet.

    (Owner will receive a courtesy call from a Doctor or Technician after the patient is

    treated.) $50 $100 $150 $250 No Limit Other Amount $_______. Initial: _______

Choose one or the other

**Please call before performing any procedures/treatments. However, if you are

    unreachable or will be out of phone service during your trip, we ask that you authorize

    Premier Animal Hospital to treat your pet (s) in the amount of:

    $50 $100 $150 $250 No Limit Other Amount $__________ Initial: ________

    * If your pet is found to have fleas, capstar will be given at Owner’s expense. Please Initial: _____

*For our guest we will provide all bedding, bowls and dietary needs unless otherwise

    specified. Therefore we strongly discourage any personal items at the spa. In the event

    that you would still like to bring personal belongings, PPRDS will not be held

    responsible for any damaged or lost items.

**PPRDS will not be held liable for any unforeseen injuries to your pets that may

    occur when more then one pet are boarded together in one kennel. In the event that

    your pets need to be separated or need medical attention we will do whatever is

    deemed necessary for your pets safety & welfare at the owner’s expense. Initial: ___

**We do not recommend boarding puppies at PPRDS that are not fully vaccinated,

    as their immune systems are not fully developed. We take the utmost precautions to

    board them away from the main population. ****

***Aggressive dogs will be charged an additional $10.00 fee per night on top of the original

    boarding cost. ***** Initial: ________

***Check out is by 1:00pm, if not picked up, you will incur a Daycare fee of half a day’s

    fee, and your pet will be placed into Daycare, where they will receive playtime and treats.

    Pick up time is before closing that day.*****

I HAVE READ THE FOLLOWING AND AGREE TO THE TERMS LISTED ABOVE:

    SIGNATURE:______________________________________ DATE: _____________

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