Boarding Agreement

Boarding Agreement
This agreement is not a form to book boarding services, it is only used to register your pet once a boarding appointment has been made. If you have not already scheduled a boarding appointment, please contact our staff at 770-788-7387.
2019 Boarding Rates:

Canine/Feline = $35 per day

Canine/Feline Boarding with medication = $45 per day

The time of day you drop off and pick up your pet does not change the boarding rate.
Owner *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
Emergency contact *

First Name Last Name
Emergency Contact Phone number *

Area Code Phone Number

Please list the name(s) of the pet(s) you will be boarding with us: *
Date of Drop-off / Pick-up *
What time will you be dropping off your pet(s)? *

: Hour Minutes AM/PM Option
Please note that pets can only be dropped off or picked up during clinic hours.

Monday 7:30 am - 7:00 pm

Tuesday 7:30 am - 5:30 pm

Wednesday 7:30 am - 7:00 pm

Thursday 7:30 am - 7:00 pm

Friday 7:30 am - 5:30 pm

Saturday 7:30 am - 12:00 pm

Sunday Closed
For the security of your pet and safety of our employees, we will only admit and/or release your pet during business hours. Please list any person(s) your pet can be released to if you cannot pick them up:
What type of food will your pet eat during their stay? *
How many times a day does your pet eat?
Amount of food given
Additional special instructions for feeding:

Will you be bringing any of your pet(s) belongings? If so, please list the items and state which pet they belong to. *
Do any of your pets require medication? *
If you answered yes above, please state the pet's name and list the required medication:
Please check any additional services you would like for your pet to have while they are boarded. Canine Bath Bundles include ear cleaning, nail trims and anal glands expressed. For feline pricing and information, please contact us.

Canine Bath Bundle (1-24 lbs) - $35.00 Canine Bath Bundle (24-50 lbs) - $50.00 Canine Bath Bundle (50-89 lbs) - $65.00 Canine Bath Bundle (90 lbs & over) - $70.00 Ear Cleaning - $15.00 Nail Trim - $12.00 Nail Dremel - $18.00 Anal Glands Expressed - $24.00
Additional special instructions for your pet(s):

Vaccination Policy *

I understand that all dogs are required to be vaccinated for Kennel Cough, DHPP and rabies to be boarded at Countryside.
Parasite Control *

I understand that all animals entering the clinic for boarding must be free of internal and external parasites or they will be treated at the owner's expense.
If your pet becomes ill while staying with us, we will notify you immediately. If we are unable to reach you or the emergency contact listed above, please indicate below your authorization for emergency services:
Medical Illness Policy *
If you have selected to allow us to perform services up to a predetermined amount, please state the amount:
*
Signature *

Clear
Name *

First Name Last Name
Should be Empty: