CLIENT NAME: <First-Name> <Last-Name>PET NAME: <Animal>

BOARDING CONTRACT

CLIENT NAME: <first-name> <last-name>PET NAME: <animal>

PHONE NUMBER: <phone>BREED: <breed>

TODAY’S DATE: <date>COLOR: <color>

I CERTIFY THAT I OWN THE ABOVE DESCRIBED ANIMAL AND DO HEREBY CONSENT AND AUTHORIZE THE ANIMAL HOSPITAL OF KANNAPOLIS, AND IT’S STAFF, TO BOARD MY PET AND TO ADMINISTER MEDICATIONS THAT THE DOCTORS DEEM NECESSARY FOR THE HEALTH AND SAFETY OF MY PET IF THE ANIMAL BECOMES ILL. I ALSO UNDERSTAND THAT IF INTESTINAL PARASITES OR FLEAS ARE SEEN, THAT I PERMIT MY PET TO BE TREATED FOR THEM. IF WE MUST TREAT YOUR PET, THERE WILL BE A MINIMAL CHARGE.

IF MY PET SHOULD INJURE ITSELF IN AN ESCAPE ATTEMPT, REFUSE FOOD, SOIL ITSELF, BECOME ILL, OR DIE WHILE IN THE HOSPITAL, I WILL HOLD THE ANIMAL HOSPITAL OF KANNAPOLIS AND IT’S STAFF FREE OF ANY RESPONSIBILITY AND/OR LIABILITY IN THE ABSENCE OF GROSS NEGLIGENCE. I AGREE THAT THE ANIMALHOSPITAL IS NOT RESPONSIBLE FOR LOST TOYS, TOWELS, COLLARS, LEASHES, OR OTHER ITEMS WHICH I HAVE LEFT WITH MY PET.

I FURTHER REALIZE THAT I AM RESPONSIBLE FOR PAYMENT FOR THE ABOVE PROCEDURES AND TREATMENTS IN FULL AT THE TIME THE ANIMAL IS DISCHARGED. IF I NEGLECT TO PICK UP THE ANIMAL WITHIN TEN (10) DAYS OF WRITTEN NOTICE THAT IT IS READY FOR RELEASE AND MAILED TO THE ABOVE ADDRESS, YOU MAY ASSUME THAT THE PET IS ABANDONED. YOU ARE THEN AUTHORIZED TO DISPOSE OF IT AS YOU SEE FIT. ABANDONMENT DOES NOT RELEASE ME OF MY OBLIGATION FOR THE BILL.

I FURTER AGREE THAT IN CASE OF NON PAYMENT, A FINANCE CHARGE OF 1½% PER MONTH (18% ANNUM) WILL BE CHARGED AND THAT ANY COLLECTION FEES OR ATTORNEY FEES WILL BE PAID BY ME.

We are unable to provide boarding services for aggressive pets.

Return Date: Daily Medication______

Vaccines Due: Have meds been given today: YES NO______

Grooming: When are meds given: A.M. ______P.M______

Feeding Schedule/Amount: Blankets ok with pet: Yes______No______

EMERGENCY PHONE NUMBERS:

Signature Date______

REGARDING THE EMERGENCY TREATMENT OF YOUR PET DURING ITS STAY

PLEASE CHOOSE ONE OF THE OPTIONS BELOW

A) Treat my pet as needed. Do any and all diagnostic test, treatments, and surgeries necessary for the well-being of my pet. I accept full financial responsibility for all charges related to the treatment of my pet(s).

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B) Treat my pet as needed, but not to exceed $. I understand that if the proposed treatment exceeds the amount designated, and I or my agent cannot be contacted, my pet will NOT receive further medical treatment even if it is life threatening. I will be responsible for all charges accrued during that time period

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