Boarding Release Boarding Release Form "*" indicates required fields Name* First Last Primary Phone Number*Emergency Contact: Name and Phone Number*This person will be contacted if we cannot reach you on the primary phone number. Arrival Date* MM slash DD slash YYYY Departure Date* MM slash DD slash YYYY *Boarding arrival/departures are only permitted Monday through Friday 7:30AM-5:30PM, Saturday/Sunday 8-8:30AM OR 5-5:30PM. Weekend/Holiday departures require prepayment of services.* I understand How many pets are boarding with us?* 1 2 3 4 Pet #1Pet Name* Pet Name Species*DogCatDoes your pet require any medication during their stay?*NoYesAn additional charge of $6 per night will be applied to pet's needing medication.Please list your pet's medications and frequency* Please provide medications in their original packaging.We can only dispense medications that are in their original container or prescription bottle.* I understandIf I don't provide enough of my pet's medication for the duration of their stay, I authorize Singing Hills Animal Hospital to dispense said medication to my pet at an additional charge* I consentAre you providing your pet's food during their stay?*NoYesWe will provide a complimentary diet of "sensitive digestion" kibble and a mixture of ground turkey, vegetables, and rice.If my pet refuses to eat, I authorize Singing Hills Animal Hospital to offer canned food at an additional charge.* I consentPlease list what type of food you are providing and feeding instructions* Would you like your pet groomed before going home?*NoYesGrooming services are offered at an additional charge. Grooms typically take place on the morning of departure. Our grooming department will contact you when your pet is ready to go home (typically after 1pm).Please choose the grooming service you would like your pet to receive*Bath and Brush OutBath and HaircutSummer ShaveLion CutPlease provide any additional information about your pet that may be relevant to their stay.Pet #2Pet Name* Pet Name Species*DogCatDoes your pet require any medication during their stay?*NoYesAn additional charge of $5 per night will be applied to pet's needing medication.Please list your pet's medications and frequency* Please provide medications in their original packaging.We can only dispense medications that are in their original container or prescription bottle.* I understandIf I don't provide enough of my pet's medication for the duration of their stay, I authorize Singing Hills Animal Hospital to dispense said medication to my pet at an additional charge* I consentAre you providing your pet's food during their stay?*NoYesWe will provide a complimentary diet of "sensitive digestion" kibble and a mixture of ground turkey, vegetables, and rice.If my pet refuses to eat, I authorize Singing Hills Animal Hospital to offer canned food at an additional charge.* I consentPlease list what type of food you are providing and feeding instructions* Would you like your pet groomed before going home?*NoYesGrooming services are offered at an additional charge. Grooms typically take place on the morning of departure. Our grooming department will contact you when your pet is ready to go home (typically after 1pm).Please choose the grooming service you would like your pet to receive*Bath and Brush OutBath and HaircutSummer ShaveLion CutPlease provide any additional information about your pet that may be relevant to their stay.Pet #3Pet Name* Pet Name Species*DogCatDoes your pet require any medication during their stay?*NoYesAn additional charge of $5 per night will be applied to pet's needing medication.Please list your pet's medications and frequency* Please provide medications in their original packaging.We can only dispense medications that are in their original container or prescription bottle.* I understandIf I don't provide enough of my pet's medication for the duration of their stay, I authorize Singing Hills Animal Hospital to dispense said medication to my pet at an additional charge* I consentAre you providing your pet's food during their stay?*NoYesWe will provide a complimentary diet of "sensitive digestion" kibble and a mixture of ground turkey, vegetables, and rice.If my pet refuses to eat, I authorize Singing Hills Animal Hospital to offer canned food at an additional charge.* I consentPlease list what type of food you are providing and feeding instructions* Would you like your pet groomed before going home?*NoYesGrooming services are offered at an additional charge. Grooms typically take place on the morning of departure. Our grooming department will contact you when your pet is ready to go home (typically after 1pm).Please choose the grooming service you would like your pet to receive*Bath and Brush OutBath and HaircutSummer ShaveLion CutPlease provide any additional information about your pet that may be relevant to their stay.Pet #4Pet Name* Pet Name Species*DogCatDoes your pet require any medication during their stay?*NoYesAn additional charge of $5 per night will be applied to pet's needing medication.Please list your pet's medications and frequency* Please provide medications in their original packaging.We can only dispense medications that are in their original container or prescription bottle.* I understandIf I don't provide enough of my pet's medication for the duration of their stay, I authorize Singing Hills Animal Hospital to dispense said medication to my pet at an additional charge* I consentAre you providing your pet's food during their stay?*NoYesWe will provide a complimentary diet of "sensitive digestion" kibble and a mixture of ground turkey, vegetables, and rice.If my pet refuses to eat, I authorize Singing Hills Animal Hospital to offer canned food at an additional charge.* I consentPlease list what type of food you are providing and feeding instructions* Would you like your pet groomed before going home?*NoYesGrooming services are offered at an additional charge. Grooms typically take place on the morning of departure. Our grooming department will contact you when your pet is ready to go home (typically after 1pm).Please choose the grooming service you would like your pet to receive*Bath and Brush OutBath and HaircutSummer ShaveLion CutPlease provide any additional information about your pet that may be relevant to their stay.Release of LiabilityTerms and Conditions* By checking this box and signing below, I hereby certify that I have read and understand this Waiver and Release of Liability and the regulations set forth above. By signing this agreement, I agree to be bound by its terms and conditions.THIS AGREEMENT is entered into by and between Singing Hills Animal Hospital (SHAH) and the pet owner listed above, with the following terms: 1. Owner authorizes Singing Hills Animal Hospital to take all necessary actions, at the sole discretion of SHAH staff and management, to maintain the health and well-being of my pet(s), and furthermore agree to be responsible for any and all expenses relating to the same, including all ancillary services requested. 2. I understand that all pets must have documentation of current exams, an annual fecal screening and vaccinations, administered by a veterinarian. Past due examinations and vaccines will be given at the owner’s expense. (Exams within a year; Canines: DAP, Leptospirosis, Bordetella, Rabies; Felines: Annual Negative FELV/FIV Testing FVRCPC)3. 3. I understand that all pets must be free of parasites (internal and external) or they will be treated at owner’s expense. 4. Singing Hills Animal Hospital reserves the right to refuse admittance to any pet and/or dismiss any pet that does not meet or maintain the health, temperament or other boarding standards. This determination shall be made at the sole discretion of Singing Hills Animal Hospital. 5. I understand Singing Hills Animal Hospital will use all reasonable precautions against injury, escape or death of my pet. The hospital staff will NOT be held liable for any unforeseen circumstances that may develop provided reasonable care and precautions are followed. 6. I understand some pets may develop diarrhea and/or vomiting due to stress, change of environment, or food. Should my pet require medical attention, I agree to treatments deemed best by the staff veterinarians and I assume full responsibility for the treatments and fees incurred. 7. Infection Canine Tracheobronchitis: According to ASPCA, “Kennel cough” is a term loosely used to describe a complex of respiratory infections – both viral and bacterial – that causes inflammation of a dog's voice box and windpipe. It's a form of bronchitis and is similar to a chest cold in humans. I understand that canine cough is unpreventable and there are over one hundred strains which are all an airborne virus and SHAH is not responsible. If my pet shows symptoms of canine cough , SHAH will make every effort to get your dog veterinary attention as soon as possible at the owner's expense. I authorize SHAH at SHAH's sole discretion, to take any steps necessary to isolate my pet to avoid further exposure to other pets in the facility. A cough suppressant or antimicrobial may be prescribed. In most cases, the signs of kennel cough gradually decrease and disappear after three weeks. Young puppies, elderly dogs and other immunocompromised animals may take up to six weeks or more to recover. Animals may remain infectious for long periods of time even after the symptoms have cleared 8. If I neglect to pick up my pet within 14 (fourteen) days of the date above, and do not notify Singing Hills Animal Hospital within that time period, Singing Hills Animal Hospital will assume that my pet has been abandoned and hereby begin abandonment proceedings. (CA Civil Code Section 1834.5) I understand my credit card will be charged appropriately. 9. We will provide bedding and toys during your pet's stay. Any personal belongings left in our care will be placed in your pet's cubby. SHAH is not responsible for any lost or damaged belongings. 10. Bones, rawhides, deer antlers and other hard chews are not permitted during boarding. This is to prevent potential damage to teeth, choking or death to your pet. 11. Singing Hills Animal Hospital maintains a clean and sanitary environment. A clean up bath may be performed during the stay if my pet becomes soiled with his/her urine/feces. ($30-$40). 12. By signing below, I am verifying that I am the rightful owner of the above named pet and the person authorized to make medical decisions for him/her. In the event of emergency, I understand that Singing Hills Animal Hospital will take all life saving measures, including the use of anesthesia, until I can be reached to discuss further treatment options. I understand that every reasonable effort will be made to contact me, but if I am unable to be reached I hereby authorize the veterinarians to proceed with treatment as deemed necessary for the well-being of my animal. I understand that I will be responsible for all charges incurred at checkout.Owner's Signature*