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Notes

Submit this form for your pet's boarding stay. Do not submit this form if you have not made a reservation. Please call first to schedule prior to filling out.

Pet Name

Pet Owner's First And Last Name

Email Address

Daytime/Emergency Phone Number

Drop Off Day

Pick Up Day

Boarding beyond one month requires payment in full after 30 days and every 30 days thereafter. If client fails to make payment or pick up pet after 30 days, then the pet will be considered abandoned and become property of Lakeside Animal Clinic.

I accept.

If my pet needs medical treatments (there will be additional charges for the treatments performed) while in the care of Lakeside Animal Clinic:

You have my permission to proceed with any treatments without contact
Call first and if unable to contact, proceed with treatment
DO NOT perform any treatments, including emergencies, without contacting me first

Pick up before noon or after noon?

Before noon
After noon

Notes

VACCINATIONS

As a way of protecting all of our patients, we require all of the following vaccinations:

DOGS - RABIES, DISTEMPER, PARAINFLUENZA, PARVO, BORDETELLA, INFLUENZA
CATS - RABIES AND FVRCP

DIET

We recommend that you bring your pet's normal diet in with you to avoid any GI upset. If you do not provide your pet's food then we will feed Purina Veterinary Prescription Diet EN dry kibble.

Diet Type

I will bring my pet's food
Please feed my pet your kennel food

At drop off, when will your pet's next feeding be due?

Will your pet need to be fed once or twice daily while boarding?

Once daily
Twice daily

Any Food Allergies?

If yes, What food is your pet allergic to?

Diet Notes

Please list amount of food to be fed and frequency and any other special instructions here.

Will you be bringing any medication for our staff to administer during your pet's stay?

If yes, please list all medications.

Please indicate when your pet's next dose of medication is due.

Please list all belongings.

Notes

We recommend that you leave with your pet only those items that are necessary for his/her comfort while staying with us. We provide every possible comfort while your pet boards. We recommend that you hang on to your leashes, collars, beds, and towels. These things can sometimes be lost or damaged while in our clinic, and we are not responsible for items that are returned damaged or soiled.

Will your pet be boarding with a housemate or pet from another family?

If yes, can pet board together in same kennel?

OVERALL CONSENT

I certify that I am the owner of the above pet, and do hereby give my consent and authorize Lakeside Animal Clinic and its staff to perform any procedure or treatments that the doctor deems necessary for the health and safety of my pet while under their care and supervision. I do hereby release Lakeside Animal Clinic and its staff from any and all liability for performing the above mentioned procedures. I realize that I am responsible for payment in full for all treatments at the time that my pet is discharged. Ifl neglect to pick up my pet within 11 days of written notice that he/she is ready for release and mailed to the given address, you are then authorized to dispose of my pet as you see fit. Abandonment does not release me from my obligations to pay the bill.

UNDERSTAND THAT LAKESIDE ANIMAL CLINIC IS NOT A 24 HOUR FACILITY. FOR PETS THAT ARE BOARDED OR HOSPITALIZED, THERE WILL BE TIMES AT NIGHT AND ON WEEKENDS WHEN MY PET WILL BE LEFT UNATTENDED. I UNDERSTAND THAT I HA VE THE OPTION OF TRANSFERRING MY PET TO A 24 HOUR CARE FACILITY OR EMERGENCY CLINIC AT CLOSING TIME. IN THE EVENT OF A FIRE, NATURAL DISASTER OR OTHER EMERGENCY, IT MAY BE IMPOSSIBLE TO GAIN ACCESS TO THE BUILDING. EVERY EFFORT WILL BE MADE TO KEEP PETS SAFE AND OUT OF DANGER.

ALL PETS DROPPED OFF WILL BE CHECKED FOR FLEAS. ANY PET WITH FLEAS WILL BE ADMINSTERED A CAPSTAR FOR $8. LONG-TERM FLEA CONTROL SHOULD BE PURCHASED AT CHECK-OUT.

At Lakeside Animal Clinic we treat our patients and their owners like family. We strive to provide the very finest in animal care. Our dedicated staff works diligently to address all your pet needs and your concerns and treat you with the utmost kindness and respect. We ask for the same kindness and understanding from you in return. Lakeside Animal Clinic has a zero-tolerance policy for abusive and/or offensive language or discourteous behavior towards our staff and doctors. By signing below, you agree to act appropriately towards our staff and understand that if you violate this policy you will be asked to seek veterinary care at another clinic that can better suit your needs.

Today's Date

Lakeside Animal Clinic is not a 24-hour facility. For pets that are hospitalized, there will be times at night and on weekends when your pet will be left unattended. You have the option of transferring your pet to a 24-hour care facility or emergency clinic at closing time. In the event of a fire, natural disaster, or other emergency, it may be impossible to gain access to the building. Every effort will be made to keep pets safe and out of danger. By Clicking below you are acknowledging that you understand our facility is not staffed between the hours of 6pm and 7am, Monday- Friday. We are open from 8am-noon on Saturdays, and we are CLOSED on Sundays. Adjustments for holiday hours will be posted. You are also acknowledging that the facility is not equipped with a fire protection sprinkler system in the event of a fire.

I accept.