Boarding Form Client NamePet's NameEmergency Phone #2ndPhone #Drop Off Date MM slash DD slash YYYY Approx. Drop Off Time : Hours Minutes AMPM AM/PMP/U Date MM slash DD slash YYYY after 2:00 pm if having groom/bath Pick up is Sat or Sun either 8 AM or 5 PM at the right side of the building. - must be PREPAIDName of Flea/Tick PreventionDate Applied MM slash DD slash YYYY (must have TICK prevention) CabanaThunder SuiteUpper SuiteCottageStandardGroom Yes No Group Play Yes No Bath Yes No Paw Pops (Frozen Yogurt Treats) (how many)Individual Play Yes No How many times per dayGroup Pool Yes No Individual Pool Yes No How many times per daySpecial Notes:Brand of food & feeding instructions: (please bag food for each individual serving in a zip lock baggie)Number of BagsName of your VeterinarianPhone numberFax over your records to 239-482-7922 or email: tailsawagginanimalhospital@comcast.net Medical Problems:List of Medications and Instructions: (must bring them in their original prescription bottle) 1. Medication name:Strength (mg)Instructions: Givetablet(s) ormis (if liquid) Times per day:Specific Time? : Hours Minutes AMPM AM/PMWith food? Yes No Special Instructions?2. Medication name:Strength (mg)Instructions: Givetablet(s) ormis (if liquid) Times per day:Specific Time? : Hours Minutes AMPM AM/PMWith food? Yes No Special Instructions?3. Medication name:Strength (mg)Instructions: Givetablet(s) ormis (if liquid) Times per day:Specific Time? : Hours Minutes AMPM AM/PMWith food? Yes No Special Instructions?4. Medication name:Strength (mg)Instructions: Givetablet(s) ormis (if liquid) Times per day:Specific Time? : Hours Minutes AMPM AM/PMWith food? Yes No Special Instructions?5. Medication name:Strength (mg)Instructions: Givetablet(s) ormis (if liquid) Times per day:Specific Time? : Hours Minutes AMPM AM/PMWith food? Yes No Special Instructions?6. Medication name:Strength (mg)Instructions: Givetablet(s) orSpecific Time? : Hours Minutes AMPM AM/PMmis (if liquid) Times per day:With food? Yes No Special Instructions?Boarding/Daycare ContractOwner:Email Address Street Address City State / Province / Region ZIP / Postal Code Phone Number2nd Phone NumberPet's Name:Species:Sex: Male Female Other Age:General Terms: Tails-A-Waggin Animal Hospital & Pet Resort (TAWAH) will exercise responsible care for the safety of your pet, and to keep the boarding premises safe and properly enclosed. Pets will be fed and watered regularly, and housed in clean, safe quarters. The TAWAH cannot guarantee against accidents, and we cannot be liable for loss or damage caused by or to our pet guests at this facility. Owner agrees to be solely responsible for any and all attacks or damage caused by owners' pet while it is at this resort. Payment/Nonpayment: The TAWAH charges for boarding space by the day. (Boarding fees are charged day-in thru day-out) Owner agrees to pay the rate for boarding in effect on the day the pet is checked into the resort. Payment balance is due upon checkout. If any charges are not paid when due, interest will accrue at 1.5% per month, or the maximum rate allowed by law. The owner will pay all collection expenses, including attorney fees. Check in/out Times: We do have Saturday 3:00 PM sharp pick-ups and Sunday 8:00 am sharp or 3:00 pm sharp. Must be pre-paid at time of check-in. Personal Items: We make every effort possible to make your pet feel at ease while he/she is staying with us. The TAWAH does not recommend bringing personal items from home as they may be lost in the laundry or soiled. TAWAH is not responsible for lost or damaged personal items. Vaccinations: Vaccinations are for the-protection of your pet, we cannot make exceptions to vaccination requirements. If proof of vaccination is not on file or provided from another veterinarian, the pet will be vaccinated and examined at the owner's expense on the arrival date, and has higher risk of contracting an illness during his or her stay. Flea/Tick: We are 100% parasite free facility; therefore, all incoming pets must be treated with an approved product. Owner/Agent will provide proof of purchase. Pets admitted to our facility must be free of internal and external parasites including intestinal worms, fleas, ticks, and mites. All pets must receive an oral or topical parasite control prior to checking in for boarding. If parasites are discovered, your pet will receive a dose of CAPSTAR, an oral flea preventative that is safe to use even if other topical flea/tick prevention has been applied. The fee for this treatment will be in addition to the boarding charges. Abandonment: If the pet is not called for within 10 days after the designated checkout time, the pet will be considered abandoned and will be handled in accordance with state law. All adoption fees and other incurred expenses will be the responsibility of the owner Deposit: TAWAH requires a non-refundable deposit equal to 50% of the boarding fees at the same time the reservation is made. This deposit guarantees the space for specified guest.. If an extended stay is required, there may be additional fees above routine boarding rates. Geriatric Pets: Older pets may experience additional stress in the lodging, daycare, grooming, or training environment TAWAH is devoted to providing exceptional care for guests, including geriatric pets. Your signature acknowledges that you are aware of and accept all age related risks to your pet. Food Policy: If your pet does not eat his/her regular diet, TAWAH will add canned food (I/D or EN) in order to entice your pet to eat. I understand additional food added will be charged to my account and will be paid upon my pet's departure from TAWAH Medications: Medications, supplements, or other items will be administered for an additional fee as directed, but medications must be presented in their original containers with instructions for administration. Group Play: There are risks and benefits associated with group socialization of dogs. I agree that the benefits outweigh the risks and that I accept the risk. I desire a socialized environment for my dog while attending services provided by TAWAH & Pet Resort and while in their care. I understand that while the staff to prevent injury, closely and carefully monitor the socialization and play. It is still possible that during the course of normal play, my dog(s) will receive minor nicks and scratches from roughhousing with other dogs. Promotional: While in the care of Tails-A-Waggin Animal Hospital & Pet Resort, my pet may be photographed/and/or videotaped. I understand that these photos may be used in the TAWAH directory, newspaper articles, clinic publications, social media sites, flyers, website and promotional purposes. I hereby release and agree to hold harmless TAWAH, and Doctors, and the staff of TAWAH from any liability. Treatment Authorization: The owner agrees that TAWAH , in its discretion, give first aid, medication, or other attention we deem it necessary for the health, and safety of your pet. TAWAH is authorized by the owner to provide veterinary care, including emergency care, at the owner's expense. If we believe that your pet is in need of care, time permitting we will attempt to contact you before providing that care, but this document serves as our authorization to provide veterinary care for your pet in the event we are unable to reach the owner. The owner is responsible for expenses of veterinary care, whether or not you have been reached in advance. Your signature on this authorization permits TAWAH to make reasonable care decisions regarding your pet; and the owner agrees to pay for all costs incurred for such treatment. In the unlikely event that a pet passes away, while a guest of TAWAH we will contact you and discuss your options of body care with you. CONSENT FOR TREATMENT: *In the event additional treatments, tests, or medications are needed, I elect TAWAH to : Contact me prior to any additional charges Yes No Do not contact me- I authorize TAWAH to preform treatment up to $ .00If this limit is to be exceeded, we will contact you at (phone #)*I am the owner or agent for the above-described animal. I assume financial responsibility for all charges incurred to the above patient and agree to pay all such charges when my pet is released from the hospital. In the event of a medical emergency, please note treatments will be rendered and the cost will be the responsibility of the client. SignatureDate MM slash DD slash YYYY Primary Contact Name:Contact Number:Alt. Contact Name:Contact Number:CAPTCHA