Name*

Phone*

Email*

Emergency Contact #*

Pick Up Date

Pick up Time

:

PROOF OF VACCINATIONS:

All pets must be current on vaccinations to enter the boarding facility. This ensures your pet’s protection as well as the safety of our other boarders. The required vaccinations include: DOGS: DA2PP (Canine Distemper), Bordetella (kennel cough), influenza, and Rabies Vaccine. CATS: FVRCP (Feline Distemper) and Rabies Vaccine. If vaccinations have been administered elsewhere, please provide documentation to that effect.

PERSONAL ITEMS:

Clean bedding will be provided for all pets boarding with us. We understand the desire to leave personal bedding with your pet, but due to cleanliness issues, we prefer to use our own bedding unless special needs of a pet’s illness require other bedding to be used. Please label any personal items left with pets with permanent markers. PEACHTREE CREEK ANIMAL HOSPITAL IS NOT RESPONSIBLE FOR DAMAGED OR LOST PERSONAL ITEMS LEFT WITH PETS. Your pets boarding area is cleaned thoroughly every day (or more often as needed) and all bedding changed and washed as necessary.

FEEDING:

Unless personal food is brought, your pet will be fed Hills prescription diet digestive care. We will be happy to feed any food that is brought with your pet. Please label the food with the pet's name and leave feeding instructions with the food.

Feeding instructions:

Next feeding is due

:

MEDICATIONS:

Any medications your pet may need will be given by our support staff. Please make sure all bottles are labeled properly and medications are in their original containers. The charge for administration is $3.00/day per pet. Please list all medications below with their dosages:

HOLIDAYS:

On major Holidays there is an additional $10/charge per pet. The entirety of this extra fee goes directly to the staff members that come in on their holiday to care for your pet. The Holidays with this charge are New Years Day, Christmas Day, Memorial Day, 4th of July, Thanksgiving Day and Labor Day. Thank you for your understanding regarding this policy.

BATHING/TOENAIL TRIM: We can give your pet a discounted bath before heading home. Bathing includes brush out, blow dry and an ear cleaning. Tending to mats will incur additional fees.

Bath ($20):

Please Select
Yes
No

Toenail trims ($20):

Please Select
Yes
No

Peachtree Creek Animal Hospital Boarding Release Form

I hereby authorize Peachtree Creek Animal Hospital, its employees, to receive, care for, vaccinate, prescribe for, medicate, test, and/or bathe my animal as they deem necessary for the health, safety, or well-being of my pet. I understand that all reasonable precautions against injury, escape or death of my pet will be used. I understand that I assume certain risks and will not hold Peachtree Creek Animal Hospital or its employees responsible in any manner or circumstances for these risks. Please understand that we cannot, and will not, board pets we deem to be too dangerous to our staff or other pets. Lastly, I understand that all responsibility for payment for services provided in this hospital for my pet is mine, due and payable at the time services are rendered. In the event of an emergency or illness appropriate medical care as determined by the veterinarian on staff will be administered. A staff member will make every effort to contact you and/or your emergency contact first before any additional services are performed. I have read and agree to all the terms listed above.

Special notes:

I have read and agree to all the terms listed above.

Owner Signature

Phone

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