Boarding Release Form – DEMO – Cheshire Partners Veterinary Website

Owner's Name:(Required)

First Last

Owner's Email(Required)

Patient Name:(Required)

Basic Information

Check in time Mon-Sat is 9:00am-2:00pm with a 1 hr. grace period. Pets needing vet services or medication should be in by 2:00 pm Mon-Fri and 1 pm on Sat. We do not offer Sunday drop off.

A $15.00 fee will apply 10 minutes after required check in time and all check ins before 9 am.

We offer Sunday pick-up between 1:00-3:00pm. If you pick up on Sunday, you are charged for Sunday and charges will be applied to your credit card on file.

All reservations require a credit card number. We require 48 hours prior to your check in date to cancel, otherwise you will be automatically charged a cancellation fee to your credit card on file.

If you bring your pets food, we ask that you pre-package each feeding.

Do not bring toys or bedding from home. We will provide bedding and furnish toys for playtime. WE DO NOT ALLOW BULLY STICKS, NYLA BONES, KNUCKLE BONES, RAW HIDES, ANTLERS OR ANYTHING SIMILAR FOR SAFETY PERCAUTIONS.

Check-out time is by noon on the day of pick-up unless your pet is receiving bathing services that day. Pets picked-up after noon will be charged an additional day of boarding.

Canine Annual Vaccine Requirement: Rabies, Distemper, Leptospirosis, Bordetella (Kennel Cough), Canine Influenza

Feline Annual Vaccine Requirement: Rabies and Distemper

All pets will be checked for fleas and ticks and monitored for internal parasites and treated as necessary at owner’s expense. PLEASE MAKE SURE YOUR PET IS CURRENT ON FLEA/TICK PREVENTION

If your pet requires medications, fluids, or insulin injections during their stay, we can administer them at an additional fee.

Boarding Request

Boarding Drop Off Date(Required)

Boarding Pick Up Date(Required)

Please let us know your pets feeding schedule(Required)

Are there any Special Instructions for feeding or anything else you would like us to know?

Is your pet on any medications?(Required)

Yes

Please list any medications and dosage

Is your pet currently on Heartworm preventatives?(Required)

Yes

Is your pet currently on Flea/Tick preventatives?(Required)

Yes

Is your pet up to date on all vaccinations?(Required)

Yes

Please list which vaccinations your pet needs.

We can vaccinate your pet while at our hospital for an additional fee.

Does your pet play well with others?(Required)

Yes

Is your pet aggressive towards toys?(Required)

Yes

Treatment Authorization if an emergency arises:

I authorize alternate contacts given at check-in to act as my representative regarding the care of my pet in the event that an emergency arises, and I cannot be reached. I understand that Cheshire Animal Hospital will use reasonable means to reach me and if they cannot they will then attempt to reach my alternative representative. If I cannot be reached, I authorize Cheshire Animal Hospital and its employees to treat my pet and to contact me:(Required)

If there are any changes in my pets health status, even minor changes.

Only if a serious matter arises. Please use your discretion.

Owner Signature:(Required)

Date(Required)

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