Boarding Agreement

Drop-off Date: *

Drop-off Time: *

Pick-up Date: *

Pick-up Time: *

REMINDER – all pets must be picked up during regular business hours unless authorized

Owner’s Name(s):

Mailing address: *

Apartment, suite, etc:

City: *

State/Province: *

ZIP / Postal Code: *

Home Phone: *

Cell Phone: *

Work Phone: *

Email Address *

Contact person in case of Emergency: *

Phone: *

(This information is required in order to board your pets at HVS )

Pet(s) Boarding:

Canine / Feline: *

Canine / Feline:

Are you providing your own food? *YesNo

Type of Food and Instructions:Ex: wet or dry food; how much at each feeding and how many times per day

Does your pet have any medical conditions that our staff should be aware of? *YesNo

If yes, please explain:

Is your pet(s) currently taking medication(s)? *YesNo

If so, list pet name, medication(s) and dosage(s) and when last given:*Please note: There will be an additional charge of $2.95/day for pets requiring medication during their stay at HVS.

List any personal items brought with your pet: *

FOR YOUR PET'S HEALTH:

In an effort to reduce the spread of infectious and zoonotic diseases, HVS does require all pets to be current on vaccinations and the appropriate documentation provided. Thank you for your support and understanding.

Dog	Cat
Rabies	Rabies
DHPP (Distemper/Parvo)	FVRCP
Bordetella (Kennel Cough)	FelV (Optional)

If my pet is not current on vaccinations or I am unable to provide proof of such, I give my permission for HVS to vaccinate in accordance with the above policy. *

If my pet is found to have fleas/ticks, I give my permission for HVS to administer medication. *

**Additional fees do apply**

Examination - List concern:

If other, please describe:

All reasonable precautions will be used to protect your pet(s) against illness, injury, escape or death during their stay at HVS. In the unlikely event of any of the above circumstances, HVS and staff will not be held liable provided that reasonable care and precautions were taken based upon company policy and AZ rules/statutes. I assume full responsibility for all expenses necessary to provide medical care as deemed appropriate by the on-staff veterinarian.

Payment: I understand that I am financially responsible for payment in full for services rendered and that payment is due upon the release of my pet. Should default occur, HVS reserves the right to forward my bill to an attorney or collection agency and I will be held responsible for all expenses including, but not limited to, collection and/or attorney fees.

Abandonment: If the pet is not called for within three days after the time specified for release and if the doctor or staff is not notified of an alternate date within the three-day period, the animal will be considered to be abandoned and may be turned over to the proper authorities as deemed necessary. It is understood that this does not relieve me from the accrued fees/debt in full.

Signature of Owner or Responsible Party: *

Date: *

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Pet(s) Boarding:

FOR YOUR PET'S HEALTH: