Boarding Policy"*" indicates required fields Name*My pet(s) will board from (dates) MM slash DD slash YYYY To (dates) MM slash DD slash YYYY Pet(s) Name Add Remove I understand that my cats/dogs must be current on their vaccinations:(Dogs: Distemper-Parvo combination, Rabies,& Bordetella) (Cats: Distemper-upper respiratory & Rabies. If my pet vaccines are due according to our medical records or if written proof of vaccinations cannot be provided, I understand that my pet will receive these vaccine(s) as well as a physical exam. I understand that this is done to protect the health & safety of my pet(s), other pets, & staff members. I also understand that should my pet(s) become ill or require medical care during their stay, that I grant Lincoln Ave Veterinary Clinic permission to do what is necessary to insure their health & that I will accept these additional financial charges. I understand that Lincoln Ave Veterinary Clinic will make every attempt to contact me should the additional charges exceed $100.00.I Understand the Above (Initial)*1. Phone numbers where I can be reached will be:*If I cannot be reached while pet(s) are here & my pet(s) become(s) seriously ill, I authorize the total amount to be spent for my pet's health to be: $2. My Pet's current weight is:3. I understand my pet will be fed Royal Canin GI low fat twice daily according to their body weight, we do not feed any other prescription diets unless otherwise provided by you. If you have provided special food for your pet, please indicate what type of food you have provided.4. Please list any & all MEDICATIONS your pet is on: (If the medication is not prescribed by this clinic, please give does & how often the medication is to be administered)5. I last gave my pet's medications: 6. There will be medication administration/medical treatment charge of $5 to $15 a day depending on frequency. 7. Please describe any bedding/toys left with your pet:8. If you have 2 pets boarding please choose one of the following: Separate Board Together I understand that even though my pets get along at home, they may not while boarding together in an unfamiliar place. I do not hold Lincoln Avenue Veterinary Clinic responsible, if there is an altercation between my pets while boarding together. I also understand, if at anytime the staff feels my pets will not get along, they will separate them.Special request I would like (PLEASE note these are additional fees): A: Examination by the veterinarian ($70-95) B: Vaccinations ($30-40) C: Tender Loving Care Package ($10/day) D: Grooming by Groomer (Fees Vary) E: Nail Trim ($25-$37) F: Dental prophylaxis;(if time allotted PLEASE sign dental consent form) G: Fluids-Fe-30lb ($17.50) K9-31lb & up ($25.00)Please list any existing allergies and/or medical conditions your pet(s) has been diagnosed with: If your pet is aggressive there will be an additional charge for boarding of $10/day. We DO NOT do TLC on aggressive pets.Pick Up Times 7am-6pm (Monday-Friday) 7am-12pm (Saturday) NO SUNDAY PICK-UPS *Pick-up Policy: All pets must be picked up before 6PM. If you arrive before 6:15PM you will be charged a late fee of $15, if you arrive after 6:15PM, your pet will be boarded overnight and a boarding fee will be applied. I understand the above and give my consent for my animal.Signature*Estimated Pick up time isCommentsThis field is for validation purposes and should be left unchanged.
