Boarding Form - Client Authorization - Frontier Veterinary Hospital, P.C.

Client Authorization

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

E-mail *

Phone *

Alternate Contact Name

First

Last

Alternate Contact Phone

Check in date *

Check out date *

Day of the week *

Estimated pick up time *

Pet information (Name/Species) and will they be alone or sharing a kennel? Please include all pets.

Accommodations: I hereby entrust Frontier Veterinary Hospital (FVH) to care for my pet(s) during his/her boarding stay. FVH will use all reasonable precautions against illness, injury, or escape of my pet, but will not be held liable or responsible in any manner whatsoever. FVH will provide accommodations deemed appropriate for the safety, health, and comfort of my pet(s). If my pet is immunocompromised or vaccineexempted, Frontier will make an effort to accommodate my pet in a low-traffic area of the hospital, however this cannot be guaranteed. *

I have read and understand.

Emergency or Illness: I have provided the above phone number(s) to reach me in case of emergency, or the name and phone number(s) of an alternate contact person who is able to authorize services if I cannot be reached. In the event of an illness or emergency, FVH will attempt to contact me or my alternate contact at the phone number(s) provided; however, I understand that if I cannot be reached within a reasonable length of time, I authorize FVH to treat my pet however is deemed necessary for his/her health and well-being, and I agree to pay for any and all expenses that may be incurred. *

I have read and understand.

Boarding Requirements: I understand that vaccines are required for boarding; cats must be current on FVRCP and Rabies vaccinations, dogs must be current on DHP, Bordetella, and Rabies vaccinations. If the required vaccines are NOT current, they will be given during my pet(s) stay, and I understand that a physical examination may be required prior to vaccinating my pet. Additionally, if my pet is found to have fleas, a flea treatment will be applied. I agree to pay all charges associated with these services. I understand that boarding my pet bears an inherent risk of communicable disease transmission, regardless of vaccine or parasite preventative administration, and I accept this risk and the cost associated with medical treatment, if necessary. *

I have read and understand.

Pick-up: I will plan to drop off and pick up my pet 30 minutes before the office closes. If I arrive after the office has closed, I understand that there is a LATE DROP OFF/PICK UP FEE of $50.00. Should my pet remain unclaimed after the date that I have stated as the pick-up date, written notice will be mailed to my address. Seven days after such written notice, I understand that the pet will be considered abandoned. It is further understood that such action will not relieve me from paying all accumulated charges, including boarding. *

I have read and understand.

Personal Belongings: I understand that pets may tear, chew and/or swallow items left in the kennel during boarding, including their own collar or the collar of a kennel mate. I accept all financial responsibility for any medical or surgical intervention that may be required should my pet(s) be harmed as a result of any items I have requested be left in the kennel. I have listed the items I want kept in my pet’s kennel on the Boarding Instruction page(s) and authorize them to be in the kennel with my pet(s) during their boarding stay. I am aware that my pet(s) are not supervised at all times, and understand that any item not included on the list will not be provided to my pet(s). *

I have read and understand.

Photos: We sometimes photograph pets that are boarding with us and share these photos on our website and social media. For your privacy, we only share your pet’s first name. *

Yes, please share my pet's photo!
No, do not share my pet's photo.

I have read the foregoing and agree. I will complete a Boarding Instructions page for each pet. I am the legal owner and financially responsible party. *

I have read and understand.

Instructions

Pet's Name *

Species *

Dog
Cat

Name of flea treatment *

Date given *

If you are providing food, indicate brand and name

We will feed your provided food at no charge or Frontier's food at a cost of $3/day

Amount

Frequency (check all that apply)

AM
Midday
PM

Next Feeding Due

If your pet runs out of the food you provided while boarding: If it is a food FVH stocks, we will open a new bag/can(s) and invoice accordingly. If it is not a food FVH stocks, we will feed your pet our standard boarding food at no additional cost.

Belongings - Please list all of your pet’s belongings. Be specific; list description with color, size, etc. *

We strongly recommend labeling your pet’s belongings- your or your pet’s name written in permanent marker on the tag or somewhere on the item. If you need a marker, please ask a receptionist; we are happy to help.

Please list any items that should NOT be placed in your pet's kennel. *

Would you like us to use our bedding in your pet's kennel? *
Yes
No

Are there medications we must administer? *
Yes
No
Medication administration fees: Once daily $6/day; Twice daily $9/day; Thrice daily $12/day.

Medications must be clearly labeled; medications that are not labeled will not be administered.

Special Note to Owners of Dogs on NSAID Medications: Some non-steroidal anti-inflammatory (NSAID) medications can cause an adverse reaction when a pet is under stress. Prescriptions such as Rimadyl, Metacam, Etogesic and Deramaxx will not be given during your pet’s stay with us. If you wish to decline this recommendation please complete the following: *
I decline the above recommendation, and I agree that I have been informed as to the risks associated with NSAID use in boarding dogs.
I choose to have the medication administered during my pet’s stay.

Do these instructions differ from what is printed on the RX label? *
Yes
No

Medication Name *

Dose (i.e. 1 pill, 1/2 pill, etc.) *

Frequency (ie. every 12 hours) *

Next Dose Due (date & time) *

Add another medication? *
Yes
No

Medication Name *

Dose (i.e. 1 pill, 1/2 pill, etc.) *

Frequency (ie. every 12 hours) *

Next Dose Due (date & time) *

Add another medication? *
Yes
No

Medication Name *

Dose (i.e. 1 pill, 1/2 pill, etc.) *

Frequency (ie. every 12 hours) *

Next Dose Due (date & time) *

Optional Packages - $10 per 15 minute session

You may select a maximum of one optional package per day, however completion of these packages will be at our staff’s discretion. Some cats dislike additional handling during boarding, and during holidays or when staff must be diverted to medical operations. You will only be charged for sessions that are completed.

Please check any optional packages you would like to include during your pet's stay with us.
Pampered Pooch – Perfect for the pampered lap dog or senior pet. Your dog will get one-on-one snuggle time with our staff and a treat.
Playful Pooch – If your dog loves to romp and play, this is the package for you! One-on-one playtime with our staff- we’ll throw a ball, tug-o- war, or do whatever activity your active dog enjoys. Feel free to make notes about your dogs favorite activities on the back of this page.

Pampered Pooch – Please indicate how many sessions total you would like during your pet's stay *

Playful Pooch – Please indicate how many sessions total you would like during your pet's stay *

Would you like to receive photos via text or email? *
Text
Email

Please check any optional packages you would like to include during your pet's stay with us.
Pet & Purr – Perfect for the pampered lap cat or senior pet. Your cat will get one-on-one snuggle time with our staff and a treat.
Pounce & Play – If your cat loves to play, this is the package for you! One-on-one playtime with our staff - we’ll tempt your kitty with string toys, catnip mice and play on the cat tree.
Brushing – If your pet’s coat requires frequent brushing at home, we can maintain your pet’s coat during boarding . Your pet must have a well-maintained coat as this service is for maintenance, not grooming or dematting.

Pet & Purr – Please indicate how many sessions total you would like during your pet's stay *

Pounce & Play – Please indicate how many sessions total you would like during your pet's stay *

Brushing – Please indicate how many sessions total you would like during your pet's stay *

Would you like to receive photos via text or email? *
Text
Email

Additional Comments

Signature *

Today's Date *

Boarding Form – Client Authorization

Client Authorization

Instructions