Hickory Pet Inn 610-825-8895 Hickory Veterinary Hospital 610-828-3054

BOARDING ADMISSION AGREEMENT

DATE: ______DATE OF EXPECTED PICK-UP: ______

PAYMENT FOR ENTIRE STAY IS EXPECTED IN FULL AT PICK-UP

PET’S NAME: ______OWNER’S NAME______

THIS BOARDING AGREEMENT AUTHORIZES HICKORY VETERINARY HOSPITAL TO RENDER MEDICAL
EMERGENCY TREATMENT AS DEEMED NECESSARY BY A DOCTOR WHILE YOUR PET IS LODGING WITH US.

ADDITIONAL AUTHORIZATION:

THE CLIENT AUTHORIZES HICKORY VETERINARY HOSPITAL TO RENDER MEDICAL TREATMENT FOR SUCH ILLNESSES AS: VOMITING, DIARRHEA, URINARY TRACT INFECTION/BLOCKAGE AND EAR INFECTIONS AS DEEMED NECESSARY BY THE DOCTORS IN CASE OF ILLNESS OR INJURY WHILE THE PET IS BOARDING.

Owner's Initials ______

AuthorizeMust Call Owner First

** If a client elects to be contacted first, they must leave at least 2 contact phone numbers. If a doctor leaves a message and does not receive a call back within 2 hours, the doctor is authorized to perform medical care as deemed necessary in case of illness or injury.

Hickory Pet Inn cannot accommodate and will not be held responsible for a medical condition of which it is not aware. If your pet has ANY medical condition which may impact his/her stay at Hickory Pet Inn, the owner MUST provide full medical records prior to arrival.

Please answer the following Questions:Explain:

DOES YOUR PET HAVE ANY CURRENT MEDICAL CONDITION? No Yes ______

Does your pet have any allergies? No Yes ______

Does your pet have Behavioral Problems?No Yes ______

Is your Pet on Behavioral Medication? No Yes______

Has your pet ever bitten anyone? No Yes ______

FEES: Our fees for dogs are based on the animal’s weight and age. The standard cat fee is always the same no matter the size or age of the cat.

Cats -$______a nightDogs - 0-15 lbs. - $______a night 16-30 lbs. - $______a night

31-70 lbs. - $______a night 71-90 lbs. - $______a night

91-120lbs. - $______a nightOver 121 lbs. - $______a night

SPECIAL REQUESTS:If you have any special circumstances or requests we will try to accommodate you in any way possible. For instance:

  1. Diet- we feedIams dry Dog/Cat food and Pedigree dog or Friskies cat canned food in our kennel. If this is not what you feed at home, the change in diet may cause your pet’s stool to be loose. If you feel this may happen with your pet, or your pet is already on a special diet please feel free to bring your own food and we will gladly feed their usual diet.
  2. Exercise- our kennel staff exercises your pet twice a day, if you feel he/she needs extra exercise while boardingplease let us know. We can customize an exercise plan for your companion.
  3. Medications- if for some reason your pet is on medication for certain conditions, our technicians can medicate them throughout their stay at the kennel.
  4. Medical services (vaccines, check lumps, ears, legs, teeth, etc) the owner must agree and authorize.

EXTRA CARE:If for some reason your pet does need extra care other than what was mentioned above, we can also providehospital/doctor services.
AN EXTRA FEE WILL BE CHARGED FOR MEDICATING PETS AT HICKORY VETERINARY HOSPITAL.

Diabetic Care - $______a night; Geriatric Boarding - $______a night; Puppy Boarding (< 6mos) - $______a night

BATHING: We will bath your pet at your request. The fee is based upon the size of your pet and the grooming necessary. This normally includes a shampoo, pedicure and brush out. The bath does not include medical problems such as anal sacs or dirty ears. If these are problems and you want a doctor to examine your pet, please let us know. Do you want your pet to receive a bath before pick-up from boarding? NO YES

ABANDONMENT OF ANIMALS: If the client does not pick up or call within 3 days after the agreed upon pick up date, a certified letter will be sent regarding the animal's abandonment. If the pet is not claimed and fees paid within the specified time set forth in the letter, the client will relinquish all rights to this abandoned animal. The animal in question will become the property of Hickory Pet Inn/Hickory Veterinary Hospital.

VACCINATIONS REQUIRED TO BOARD: Dogs must be vaccinated for: Rabies, Distemper, Parvovirus, Bordetella and Canine Influenza. Cats must be vaccinated for: Rabies and FVRCP. You must provide proof that your pet is up to date on these vaccines. If your pet requires vaccination we can schedule this to be done at Hickory Veterinary Hospital.

Signature of Owner or Agent: Date: ______

Telephone Numbers 1.) _____ 2.) ____ Employee Initials: ______

BRDGAGMT 9/2011