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Home
About Us
Location & Hours
Our Team
Office tour
Contact
Fear Free
Services
Medical Services
Pet Care
Surgical Services
New Clients
Forms
Payment Options
Pet Health
Pet Health Library
Pet Health Checker
News
Fear Free
Pharmacy
Boarding Release Form
Owner Name
First
Last
Pet Name
First
PROOF IS REQUIRED IF VACCINES ARE CURRENT.
All pets must be current on required vaccinations. If they are not current and no proof is provided I understand that these vaccines will be administered at my expense.
Canine Vaccines/Lab Test
Vaccine Wellness Examination
I accept
Rabies
I accept
Current
DHP/P-L4
I accept
Current
Bordetella
I accept
Current
Influenza N2/N8
I accept
Current
Lepto
I accept
I decline
Current
Heartworm Test
I accept
I decline
Current
Fecal
I accept
I decline
Current
Feline Vaccines/Lab Test
Vaccine Wellness Examination
I accept
Rabies
I accept
Current
FVRCP-C
I accept
I decline
Current
Leukemia
I accept
I decline
Current
Fecal
I accept
I decline
Current
Canine/Feline Annual Blood Work
I accept
I decline
Current
Feeding Instructions
(type of food, how much, and how often)
Does your pet need any medications while boarding?
Yes
No
If yes additional charges will be applied
If yes please give names of any medications and the dosage to be given:
Emergency Phone
REQUIREMENTS FOR BOARDING
All pets must be free of external parasites (ex. ticks, fleas, etc.), or they will be treated at owner's expense.
If we observe your pet experiencing fear, anxiety or stress, we have your permission to treat your pet accordingly. This may include giving your pet medication which will be an additional cost.
Yes
No
Call Me
If one of your pets becomes ill, we will call the emergency number above regarding your pet’s symptoms, treatment options, and estimate of additional costs. If no one can be reached, however, please indicate your wishes below should your pet require treatment to relieve immediate discomfort or to resolve an important medical condition.
Town & Country Animal Hospital has my permission to do whatever is necessary should an emergency arise.
Do not administer any medical treatment until specific authorization is given.
I authorize up to
$100
$250
4. Pets may be picked up between 8:00 am - 7:30 pm Monday through Friday, and 8:00 am - 11:30 am on Saturday. 5. Personal items may be left at your own risk. We are not responsible for loss or damage. Submit below to agree that you have read the boarding requirements and understand the hospital's policies.
