Mooresville, NC

Boarding Release Form

Please fill out the form below prior to your visit!

Patient Name *

Breed *

Sex *

Age *

Color *

Release of Liability:

I hereby consent and authorize Harbor Point Animal Hospital to receive and board my pet(s). I understand the hospital will use all reasonable precautions for the safekeeping of the described pet(s), but the hospital will not be held responsible in any manner whatsoever on account of medical situations that may arise, as it is thoroughly understood that I assume all risks. I also understand that hospital personnel are not present continuously after normal business hours. *

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Vaccinations

I further understand the hospital policy stating that all vaccinations must be up to date at the time of boarding. If vaccinations are overdue I authorize those vaccines to be updated at the Owner's expense. This includes rabies and distemper for cats, and rabies, distemper, and Bordetella (kennel cough) for dogs. These vaccination requirements reduce the risk to both the hospital employees and the boarding pets. All pets need to have had an intestinal parasite screen in the last 12 months. If the test is positive I understand that I will be charged for the treatment of the intestinal parasite. *

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Special Diet

We recommend that all pets stay on their normal diet while boarding to help with GI issues that are common during boarding. If my pet requires special or prescription food, it will be my responsibility to provide such food during my pet’s stay. If I do not bring my pet's food with me and the hospital has to supply it, I understand that I will be charged accordingly. If no special diet requirements exist, all boarded pets will receive a high quality maintenance type diet (Science Diet), at owner's expense. *

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Upper Respiratory Infection

I know my pet is healthy and not coughing, gagging or sneezing and is free of nasal discharge associated with infection. I also know my pet has not been around any other pet who was showing these symptoms in the last 2 weeks. I understand that Harbor Point takes the utmost care in cleaning and disinfecting their facility. Therefore, the hospital reserves the right to place patients who are coughing or showing signs of upper respiratory infection into the isolation ward for the duration of their stay. *

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Financial Obligation

Balances for boarding, vaccinations, bathing and any necessary treatments are to be paid when pets check out. I agree to pay any amounts rendered. In the event of an unforeseen emergency, I authorize $_______ to use towards emergency care until I can be reached by phone. *

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Enter ($) amount from above statement *

I elect for: *

FULL
CPR
DNR

Boarding Animals Together

Harbor Point does not recommend boarding family pets together because: 1. If one of the pets vomits, isn't eating, or is having bowel problems, it is difficult to ascertain which pet is ill. 2. Boarding can be stressful to some animals and can cause pets to fight while in the same kennel -- even though they might not fight at home. I understand, as owner of the pets named above, the reasons that Harbor Point does not recommend that pets be boarded together. However, I prefer my pets be boarded together in the same compartment, and release Harbor Point from any liability that may result from that decision. Harbor Point reserves the right to separate pets for the remainder of their stay if deemed necessary. *

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Play Time

I understand that Harbor Point will not be liable, financially or otherwise, for injuries to my dog, me, or any property of mine while my dog is participating in group play. I understand it is my responsibility to notify staff in writing at time of drop off if I want my dog to only receive individual play time. I hereby release Harbor Point of any liability of any kind arising from my dog's participation in group play. *

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Special Instructions and Medications

I understand there may be an additional charge for medicating boarding pets. *

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By signing below, I acknowledge that I have carefully read and understand this entire form.

Clear Signature

Owner's Signature

Owner's Name *

First

Last

Email *

Date *

Emergency Contact Number *

Contact Name *

First

Last

Secondary Emergency Contact Number

Contact Name

First

Last

Mooresville, NC

Boarding Release Form

Release of Liability:

Vaccinations

Special Diet

Upper Respiratory Infection

Financial Obligation

Boarding Animals Together

Play Time

Special Instructions and Medications

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