Step 1 of 2 50% Boarding Pick-Up and Drop-Off Times Boarding Pick-Up Times Boarding Drop-Off Times Monday-Friday: 8:00 a.m. – 6:00 p.m Monday-Friday: 12 p.m.- 6:00 p.m Saturday: 8:00 a.m. – 4:00 p.m. Saturday: 10:00 a.m. - 4:00 p.m. Sunday: 8:00 a.m. -12:00 p.m. Sunday: 10:00 a.m. – 12:00 p.m. OwnerPet's NameDate of Pick-up MM slash DD slash YYYY Time of Pick-up Hours : Minutes AM PM AM/PM Emergency Contacts (Two people we can contact who WILL NOT be with you while you are away): 1st Contact's Name2nd Contact's Name1st Contact's Phone Number2nd Contact's Phone Number1st Contact's Email 2nd Contact's Email *Boarding Rate Are Determined by Animal Species & Weight *These Rates DO NOT include Medical Care or Clean-Ups Needed While Boarding* How much do you feed you pet per meal? (Please be as specific as possible)How often should the litter/bedding be changed?Should all the litter/bedding be changed each time or just "spot" cleaned?Other Information PLEASE READ THE FOLLOWING BEFORE AGREEING: If tranquilization / sedation is necessary for treatment or handling of my pet, I give my permission for Montgomery Animal Hospital to administer such medication(s). I understand that there is a charge for such medications. All Animals entering Montgomery Animal Hospital MUST be up to date on vaccinations and free of external parasites (fleas, ticks, etc.) or they will be treated upon entry at the owner's expense. I authorize Montgomery Animal Hospital to treat my animal should he or she develop a medical problem while boarding, and I agree to pay for all exams and treatment services rendered. I agree to contact Montgomery Animal Hospital if I am unable to pick up my pet as scheduled. I agree to pay in full for all services rendered by Montgomery Animal Hospital and to pay for those services at the time of discharge. PETS ARE RELEASED ONLY DURING REGULAR HOSPITAL HOURS. If I neglect to pick up my pet within 10 days of the scheduled date, Montgomery Animal Hospital may assume that my pet has been abandoned and may arrange for disposal of my pet in any way deemed necessary. Should I abandon my pet, I understand that I am liable for all charges incurred, that I will be reported to the authorities, and that I may be subject to prosecution. I understand that DISCHARGE TIME IS 9 AM, and that an additional day of boarding may be assessed for all animals picked up after that time.SignatureDate MM slash DD slash YYYY MedicationsNameDosageAmount/Frequency Add RemoveBelongingsItemItem Description (color, size) Add RemoveHave you noticed any of the following over the past month? Vomiting Diarrhea Coughing Sneezing Limping Loss of appetite Increased appetite Other Please explain here:
