What is the best way to contact you?
I authorize my emergency contact to make medical and financial decisions for, as well as pick up, my pet(s) if I am unable to be reached.
What is the best way to contact the emergency contact?
Pet Information
Species
Are they on any medications?
Do they have any known allergies, to vaccines or otherwise?
We provide Hill’s Science Diet Sensitive Skin & Stomach dry food at no additional cost while boarding.
Any canned food or prescription diet offered will be an additional charge.
Please be advised that there is an additional charge for food that requires cooking or reheating in addition to feeding more than three times daily.
Did you bring their food or will they be eating our food?
If you brought your own food and it runs out during their stay how would you like us to proceed?
Please acknowledge that your pet is up-to-date on flea prevention as a requirement to board. If prevention is due or fleas are found on pet, then prevention will be applied at owner’s expense. *
Please acknowledge that Animal Medical West will not be held responsible for lost or damaged personal items left with your pet. *
Group Play Authorization
Group play is intended only for spayed and neutered dogs that interact well with other dogs.
By authorizing group play you are allowing Animal Medical West to include your animal in group play while in our care with the understanding of the following guidelines:
-
Animal Medical West will provide sufficient staff to monitor all play groups and will do our best to screen dogs prior to entry into the group play. However, any information on previous positive and negative experiences with other animals is extremely important in allowing us to provide a safe and fun environment for you animal.
-
It should also be understood that any time that dogs interact with each other, there is a risk for injuries including scratches, bites, and other life-threatening trauma.
-
Animal Medical West strictly requires all of the boarding, grooming, and daycare animals to be current on vaccines and intestinal parasite/flea control. However, there still remains a risk of the transmission of upper respiratory infections, diarrhea, flea, and other communicable diseases.
-
Animal Medical West will not be held financially responsible for any expenses that may occur should your animal suffer any injury or illness due to their involvement in group play.
-
Injuries will be treated by the veterinary staff at the owner’s expense and will be contacted as soon as possible.
Do you authorize group play for your pet?
Is there anything pertaining to their behavior with other animals and humans that we should know?
Disaster Agreement
In an effort to provide you, our client, with our mission in the event of a disaster, the following plan has been developed.
-
Plan to take your pet with you. Public shelters will not allow pets.
-
If you are going to evacuate, make arrangements for your pet in a non-evacuation zone.
-
If your pet is boarding, we will need an emergency contact person who would be able to pick-up your pet, if our facility is ordered to evacuate.
-
If your pet is boarding and you are unable to make arrangements for your pet to be picked up, we will not be able to evacuate your pet to a designated non-evacuation zone.
-
If evacuated, your pet will be temporarily housed in an air-line approved pet carrier or crate. The crate shall be solid on all sides with a grated metal door and holes for ventilation.
-
We suggest that owners prepare a disaster pet supply kit to assist us in our efforts to provide care for your pet.
-
Using the emergency phone number indicated on your boarding form, and pending communication systems are functioning, you will be updated on the welfare of your pet.
-
We make no implied or expressed guarantee that our facility could withstand a disaster. Every effort shall be made to protect your pet as well as the employees of Animal Medical West.
-
A “Category-3” hurricane has sustained winds of 111-130 mph and is considered a major hurricane. In the event of such a hurricane, animals will be secured and personnel will be instructed to go home and seek shelter.
-
Mild sedation may be required for some pets; sedation will be administered at the discretion of the veterinarian. It is in your pet’s best interest to remain calm.
-
If our facility is damaged, and your pet is injured, we will make every effort to provide first aid.
-
If your pet is severely injured, and we are unable to provide advanced medical care for whatever reason, at their discretion, our veterinarians will humanely euthanasia your pet. Caring for your pet is our utmost concern; however we do not want any pet to suffer.
ACKNOWLEDGEMENT:
I am the owner, or agent for the owner, of the above-described animal and have the authority to execute this acknowledgement. I hereby authorize Animal Medical West to medicate, anesthetize, treat and perform any surgical procedure(s), as are in the opinion of the veterinarian, necessary and advisable for my pet’s health in the event of an emergency. I accept all procedures to be done to the best of the abilities of the professional staff, and I realize that no guarantee or warranty can ethically or professionally be made regarding the results or outcome. I assume all financial responsibility, and understand that payment is due upon completion of service.
Owner acknowledgement/acceptance *
OWNER RELEASE:
("I" refers to the Pet's Owner) Animal Medical West will use all reasonable precaution against injury, escape, or death of my pet. Animal Medical West and its employee's will NOT be held liable for any problems that develop during my pet's stay provided reasonable care and precautions are followed.
Pets may become ill while boarding, in addition, but not limited to being exposued to communicable diseases. Every effort will be made to contact you should your pet become ill or injured while boarding, however you are responsible for any charges incurred while treating your pet and agree to hold the staff of Animal Medical West harmless from expenses incurred.
Pets that become excessively soiled while boarding will be bathed, if necessary, at the client’s expense.
Dogs sharing a run may be subject to an additional charge by night if we must separate due to aggression or having to be separated or monitored during meal times.
Though every attempt will be made to reach you, should problems arise in your absence, we will perform any necessary treatment to ensure your pet’s good health. A change in hospital status may need to occur based on the veterinarian’s medical assessment (i.e. to medical boarding or hospitalization). This would necessitate additional costs for medical treatment and nursing care.
I release the Animal Medical West of all liability should my pet’s life be lost due to unforeseen situations, including fire and natural catastrophe.
I understand that if I neglect to call or pick-up my pet after five (5) days of the stated discharge date, the Animal Medical West will assume that I have abandoned my pet. I understand the Animal Medical West will abide by standard legal steps for abandoned pets. Furthermore, I agree to pay any additional charges incurred after said intended discharge date, whether or not I collect my pet within that 5-day period.
I understand in some circumstances a monetary deposit will be required prior to boarding stay.
Furthermore, I agree to pay the balance in full upon discharge from Animal Medical West.
I understand that I am free to call at any time during my pet’s stay at Animal Medical West for updates regarding my pet.
If I would like to visit my pet while boarding, I have been informed that I must call to schedule visitation. I understand that in the event that an emergency arises with another patient during my visit I may be asked to leave.
Please sign below acknowledging that you are familiar with these boarding policies, accepting all risks and responsibility for any costs incurred while your pet is under the care of Animal Medical West.
Owner Signature:
