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

Pets may be picked up between 8:00 am - 5:30 pm Monday through Friday, and 8:00 am - 11:30 am on Saturday. Personal items may be left at your own risk. We are not responsible for loss or damage.

We require payment in full at the time of service.

Payment Methods: Cash, Check, Visa, MasterCard, Discover, American Express or Care Credit (Some conditions apply and subject to credit approval)

By typing my full name in the space below I hereby certify that I have read the boarding requirements and understand the hospital's policies. I agree to the foregoing terms of payment and I understand that this constitutes an electronic signature**

Monday	8:00am – 6:00pm
Tuesday	8:00am – 6:00pm
Wednesday	8:00am – 6:00pm
Thursday	8:00am – 6:00pm
Friday	8:00am – 6:00pm
Saturday	8:00am – 12:00pm
Sunday	Closed

PROOF IS REQUIRED IF VACCINES ARE CURRENT.

Canine Vaccines/Lab Test

Feline Vaccines/Lab Test

REQUIREMENTS FOR BOARDING

We require payment in full at the time of service.

Contact Us

Hours of Operation