GreenbeltVeterinaryHospital and Pet Resort

BOARDING AGREEMENT

Pet’s Name:

Owner’s Name:

Admission Date:Release Date:

Phone numbers where owner can be reached:

1. I consent and authorize GreenbeltVeterinaryHospital and Pet Resort (Greenbelt) to

board, examine, prescribe for and provide medical and/or surgical treatment, as it deems necessary. Greenbelt will make reasonable efforts to obtain permission prior to performing any treatment, surgery or diagnostic procedures.Only in case of emergency.

2. Should Greenbelt be unable to contact me, I authorize Greenbelt to contact the following person(s) who have my complete permission to authorize any and all medical procedures on my animals as if the animals belong to the individuals named:

Contact’s Name:

Phone: Home CellWork

Contact’s Name:

Phone: HomeCellWork

3. I agree to hold Greenbelt harmless should any injury to my pet(s) occur during normal activities of exercise, boarding, training, bathing or other routine activities of maintaining and boarding my pet(s).

4. I agree to reimburse Greenbelt for any and all damage caused by my pet(s) during their stay at Greenbelt.

5. I further agree to pick up my animals on the release date. Should an emergency arise and I am unable to pick up my animal(s) on the designated date, I will notify Greenbelt as soon as possible of the change in my schedule. In this circumstance, realizing that Greenbelt may not have room to accommodate my animal(s) due to other pets being scheduled for the facilities, I authorize Greenbelt to place my pet(s) in whatever accommodations are available at Greenbelt and agree to pay the standard rate for the accommodations provided.

6. I further understand that if I fail to pick up the above-described animal(s) or to notify Greenbelt of any change in my plans to pick up the above-described animal(s) and to make arrangements satisfactory to Greenbelt, the above-described animal(s) will be deemed for all purposes to be abandoned by me at 9:00 a.m. on the second day following the scheduled pick-up date as designated above. If this situation should arise, I HEREBY GRANT, SELL AND CONVEY all of my rights, title and interest in and to said above named animal(s) unto Greenbelt. I understand that Greenbelt will then have the right to dispose of the above-described animal(s) as it deems best. I further agree to release and forever discharge the hospital, doctors, agents, employees and representatives of and from any and all claims or cause of action of any kind arising out of my failure to pick up said animal(s).

7. I FURTHER UNDERSTAND THAT I AM ENTITLED TO TWELVE (12) DAYS NOTICE BY CERTIFIED MAIL AT MY LAST KNOWN ADDRESS THAT SUCH ABOVE DESCRIBED ANIMAL(S) ARE CONSIDERED ABANDONED, AND I HEREBY WAIVE ALL STATUTORY NOTICE REQUIREMENTS OF WHICH I MAY BE ENTITLED.

8. I request that my pet(s) be fed according to the listed specifications:

Feed:ampm

Food:as provided by Greenbelt

own food (please list)

Amount of food:The recommended amount of food per feeding is 1 cup of dry food per 20 pounds of body weight for an adult pet and 1 cup of dry food per 10 pounds of body weight for a pet less than 12 months of age.

These are the guidelines used for every pet that stays with GreenbeltVeterinaryHospital and Pet Resort.

  • Greenbelt Veterinary Hospital and Pet Resort provides scheduled feedings 2 times a day for any pets that may be staying with us.
  • No raw foods will be fed during your pet’s stay.

*Please list any Pre-existing Conditions:

______

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9. My pet needs the following medications during boarding (please list drug name, instructions and dosage):

Drug:

Drug:

Drug:

  • Any medications that need to be given during your pet’s stay must be dropped off and must be in the original container.
  • These medications will be counted in front of the owner prior to drop off.

To ensure your pet’s comfort while visiting with us we do offer Solliquin & Fortiflora for calming and GI stress relief. These are both all natural supplements.

  • Please initial to allow consent for supplements to be given.

______

10. Items left with pet:

11. While my pet(s) are in the facility, the following services are requested:

Nail Trim $13 Anal gland expression $15 SPA $33(bath, nail trim, EAG,teeth bushed, ears cleaned.)

I understand that any veterinary services needed, will require an appointment be set prior to or at time of pick-up.

12. Your pet will be inspected for fleas and ticks upon arrival. If any of these are noted, they will be treated at your expense.

13. PETS WILL ONLY BE ACCEPTED AND RELEASED DURING PUBLISHED OFFICE HOURS.

Owner or Agent Date