Step 1 of 2 50% Boarding Release FormOwner(Required) Pet(s)(Required) Drop Off Date(Required) MM slash DD slash YYYY Pick Up Date(Required) MM slash DD slash YYYY Phone where you can be reached(Required)Emergency Phone if different(Required)Options * In case of a medical emergency and you can not be reached how much can be spent on medical $______ Do you want your pet to have an exam by Veterinarian? $30.90 * Do you want your pet bathed before he/she goes home? $(Required) Please check all that apply No bath Bath$23.00 Ear Cleaning $14.25 Nail Trim $7.25 All pets are required to have a current fecal exam within 6 months of boarding and must have flea and tick prevention on them provided by your veterinarian. I understand that my pet will, be released DURING OFFICE HOURS. ONLY AND THAT FULL PAYMENT IS REQUIRED UPON RELEASE OF MY PET. A Cash/Credit deposit may be required. Boarding fees per night (charges are per night-no. half days): All dugs and cats $23.00 I understand that should my pet injure itself in an Attempt to escape, refuse food, suddenly become ill and die, or succumb to the effects of natural disasters (hurricanes, lightening, tornadoes) I cannot hold Portland Veterinary Hospital liable in the absence of gross negligence as provided state law. If i fail to retrieve my pet by the above stated pick up date without notification, I realize that state law (Article 7465C of vemon's Texas Statutes) allows the veterinarian to dispose of any animal abandoned in their care if they give notice of their intent to do so by certified mail sent to the last known address of the owner. The veterinarian must allow the owner 12days from the mailing of the certified letter to retrieve the animal The giving of this cerified letter does not relieve the owner of liability of full payment of all services rendered. If my pet becomes ill while boarding and the veterinarian cannot get in touch with me, I okay the necessary diagnostics/treatment Until I can be reached. Before your pet(s) enter our kennels. your pet will be given a Capstar with a charge of $6.39 if your pet has ticks he or she will be given a bath. Immediately .Depending on the pet's weight and the severity Of the ticks determines pricing.Signature(Required)Date(Required) MM slash DD slash YYYY Boarding Information SheetWe want to provide the best care for or Pet while he/she is in our care. Please answer the following question so that we may get to know your pet.Is your pet eating normally?(Required) Yes No is your pet drinking water excessively?(Required) Yes No Does your pet have any dental issues that prevent him/ her from eating normally?(Required) Yes No Is your pet roughing, hacking or sneezing?(Required) Yes No We feed Hill's Science Diet Sensitive Stomach. lf your pet has digestive issues or gets a nervous stomach you may want to bring your pet's own food.List your pet's food and feeding instructions below if you bring your own food:List any medications or supplements your pet ls on. Give detailed instruction for each medication.List blankets, leashes, collars, or other belongings you will be leaving with your pet:Does your pet have any allergies?(Required) Yes No If so what Is your pet allergic to?(Required)What form If flea and tick prevention is your pet on?We will give your pet an oral Capstar upon arrival if your pet is not already on an oral flea and tick medication. You may bring your own Capstar but if we give one from our supply the charge is $5.75.Do you have any concerns or special instructions for your pet ?What is a good emergency number to contact you ? Signature(Required)Date(Required) MM slash DD slash YYYY