Boarding Consent Form Please enable JavaScript in your browser to complete this form.Client Name *FirstLastPet name *Phone *Email *Hospital and boarding policiesLeaving toys, bedding, and other personal items is strongly discouraged. They are difficult to keep track of if cleaned/laundered. Towne Animal Clinic will not replace or compensate for any damaged or lost items, and may remove any items that interfere with our care of your companion. *InitialBoarders must be current on: Rabies, Distemper, & Bordetella (Dogs) or Rabies & Distemper (Cats/Ferrets). If any of these are not current or verifiable, they will be given. If fleas or ticks are found upon admission, your pet will be treated. Fees for vaccinations, flea/tick treatment, boarding and administration of medications are due at the time of discharge. *InitialWe will try to contact you about major problems, but if minor problems are found or occur while boarding, do we have your permission to treat them without contacting you? *InitialIf, to maintain proper hygiene, your pet requires frequent bathing or bedding changes due to cage soiling, an additional fee of $10 per day will be added to boarding fees. *InitialThis facility does not have 24 hour supervision. If your pet is hospitalized and needs constant supervision, he or she will be transferred to an overnight care facility. *InitialPick up times: M-F 9:00AM - 7:30PM (12:00PM - 8PM if bath is given) Sat 9:00am - 12:30PM and Sun: ClosedPlanned Pick Up Date *Planned Pick Up Time *I authorize indicated procedures and assume full financial responsibility for fees incurred while my pet is boarding at Towne Animal Clinic. I understand that any balance due must be paid at discharge and that I am responsible for any and all collection and attorney fees associated with unpaid charges and returned checks.What do you feed your pet:Brand *Quantity *Times Per Day *What medications will we be administering while your pet is here:Medication *Milligram *Quantity *Frequency *Add More Medications *YesNoMedication *Milligram *Quantity *Frequency *Add More Medications *YesNoMedication *Milligram *Quantity *Frequency *When is the next dose of medication due? *Any special notes regarding your pet’s behavior or normal routine we should be aware of: *Procedures to be completed while your pet is staying with us: check all that apply *Trim Nails $23.00 Clip Matts $15.75 Express Anal Glands $43.25 Clean Ears $40.75Pluck Ears $34.50CANINE reduced rate clean up bath. *Must board 2 or more days* $37.75None of the aboveList any other medical procedures to be performed while boarding: *Submit