Client Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Alternate Phone Number

Emergency Contact In Case You Are Unreachable

First

Last

Emergency Contact Phone Number

Email *

Pet's Name *

Type of Pet *

Dog
Cat
Other

Sex *

Male (Intact)
Male (Neutered)
Female (Intact)
Female (Neutered)

Breed *

Color *

Age/Date of Birth

Additional Pets Boarded (if any)

Arrival Date

Departure Date

Food My Pet Eats (type "clinic" if we will feed your pet the clinic food) *

How Often My Pet Eats *

Quantity To Feed My Pet *

Additional Feeding Information

Last Time Fed

Does your pet have any medical conditions we need to be aware of? *

Yes
No

If yes please explain including any medicines we should administer:

Additional Services

Nail Trim: $21.00
Ear Cleaning: $10.71
Bath on Check-out Day (required for dogs staying longer than 4 days): $20.00
Daily Text Message - Included!

To make your pet feel at home, we strongly recommend that you provide pre-portioned meals to be served while you are gone, however, we are happy to accommodate his/her nutritional needs if you prefer. Fresh water will be available at all times. Your pet’s quarters are cleaned and sanitized at least twice each day. Outside potty breaks will be provided three times each day under the supervision of a professional staff member. Medication or vitamins brought from home will be administered. You may request that special services be provided while your pet is in our care by checking the appropriate boxes above. Our staff would be happy to answer any questions that you have about these services. When your pet returns home, please do not allow him/her to eat or drink excessively. This is a common issue and often causes vomiting and/or diarrhea. Wait at least one hour before giving a small portion of food or water. Please call if you have any questions. Check in is available during any of our open hours. Check out time is prior to noon, Monday through Saturday.

AUTHORIZATION *

I authorize Lone Tree Animal Care Center (LTACC) to keep the above named pet during my absence. I understand that in case of any illness or injury I, the undersigned, do hereby give my consent for LTACC to treat, prescribe for, or operate/sedate my pet while boarding at LTACC only after attempting to contact me. By signing this I understand that a staff member will not be on the premises after regular working hours. Pets are admitted and discharged during operating hours.
I understand all animals must have had vaccinations through a licensed veterinarian within the last 12 months. Dogs are required to have an exam, Distemper/parvo, Rabies, and Bordetella. Cats are required to have an exam, FVRCP, and Rabies. Pets also must be current on flea/tick treatment upon admission. We recommend vaccinations be administered at least 7 days prior to boarding. If the pet is not current I authorize LTACC to administer any vaccinations/treatments and I will accept full financial responsibility for them. Dogs and cats exempt (i.e. age, medical conditions) from any preventative care requirements must provide proof from their veterinarian or be determined exempt by our trained staff.
I understand my pet will be checked for fleas upon arrival. If fleas are noted, LTACC will administer Capstar for immediate treatment, and will also apply a topical prevention that lasts 30 days. I understand the communicable nature of fleas/ticks, and will be held financially accountable for the treatments.
LTACC reserves the right NOT to board pets if they are aggressive, sick, intact, in-heat, not current on preventative care, less than 12 weeks of age, or for other reasons based on the discretion of staff. LTACC will also use all reasonable precautions against illness, injury, escape of my pet, or loss/destruction of personal items, but they will not be held liable or responsible in any manner whatever, under any circumstances, on account of care, treatment, or safekeeping of my animals & their belongings, as it is thoroughly understood that I assume all risks. Should my pet remain unclaimed 5 days after the date, which I have stated as the pick up date, I understand a phone call will be made in attempt to reach myself &/or the emergency contact. If no response, then the pet will be considered abandoned and LTACC will proceed in the best interest of the pet. It is further understood that such actions will not release me from paying all costs of boarding services and use of the hospital provided by LTACC. I will be responsible for full payment of any and all services rendered to my animal. Boarding fees are due in full at the time of check-out. Pets boarding must checked out by noon, otherwise will be charged a full day’s rate. Dogs boarding longer than 4 days will receive a bath on their scheduled go home date. This will be an additional charge.

Signature *

Signature Date *

Boarding Consent Form

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