Boarding Agreement

Name *

Name

First

Last

Email *

Phone *

Address *

Address

City

State/Province

Zip/Postal

Emergency Contact Name *

Emergency Contact Number *

Name(s) of pet(s) boarding with us: *

Date of Drop Off *

Date of Pickup *

Drop Off Time *

Please note that pets can only be dropped off or picked up during clinic hours. Monday & Thursday: 7:30am - 7:00pm Tuesday & Wednesday: 7:30am - 5:30pm Friday: 7:30am - 5:00pm Saturday: 7:30am - 12:00pm Sunday: Closed

Please list any person(s) your pet can be released to if you cannot pick them up:

What will your pet eat during their stay? *

I'm bringing their food

Please feed my pet the Royal Canin Diet

Meals Per Day

Cups of Food per Meal

Special instructions for feeding?

Will you be bringing any of your pets belongings? If so, please list the items and state which pet they belong to. *

Do any of your pets require medication? *

Yes

If you answered yes above, please state the pet's name and list the required medication

Other special instructions?

‍Please check any additional services you would like for your pet to have while they are boarded. For feline pricing and information, please contact us at 470-441-7170

Canine Bath Bundle

Ear Cleaning

Nail Dremel

Nail Trim

Anal Glands Expressed

Vaccination Policy *

I understand that all dogs are required to be vaccinated for Kennel Cough, DHPP and rabies to be boarded at Countryside.

Parasite Control *

I understand that all animals entering the clinic for boarding must be free of internal and external parasites or they will be treated at the owner's expense.

Medical Illness Policy: ‍If your pet becomes ill while staying with us, we will notify you immediately. If we are unable to reach you or the emergency contact listed above, please indicate below your authorization for emergency services: *

If you selected "Perform services up to a predetermined amount," please state the amount: *

I have read and understand this agreement. I fully intend to pick up my pet(s) on the above date. If I need to extend the length of stay, I will notify the clinic as soon as possible.

Signature *