Animal Medical Clinic - Boarding Consent Form For Cats

1
Client InformationIf boarding more than one pet, please complete a boarding form for each pet.
Your Name
Cat’s Name
Your Email
2
Best emergency phone number while your cat is staying with us* This field is required.
3
Cat’s food / Feeding instructions / Medications / Other instructions* This field is required.
4
Required vaccines for boarding

(All vaccines are included at no additional charge with the Healthy Feline Club.)

* Rabies - $33.60
* FVRCP - $27.30
5
Additional Services for your catHealthy Feline Club (HFC) $209. Includes doctor exam (with a free wellness exam in six months), vaccines, Early Detection Bloodwork, intestinal parasite test, $2 nail trims for the year, and a $20 discount applicable to this boarding visit.
Healthy Feline Club (HFC) $219.50
Nail trim $17.90 ($2 with HFC)
Feline Leukemia vaccine $29.40 ($0 with HFC)
Intestinal Parasite test $35.70 ($0 witih HFC)
Early Detection Bloodwork: $93.45 ($0 with HFC) - *Doctor exam required
6
Comprehensive doctor exam $58.80 (Healthy Pet is $0 with HFC)Please list any concerns for the doctor
Huge
Large
Normal
Small
Ok
Ok
7
Comprehensive Doctor Exam – Sick Pet $56Please provide details for the doctor
Huge
Large
Normal
Small
Ok
Ok
8
Medication/Prevention refills needed
9
Any other information for us or concerns about your cat?
10
Please check ONE of these 2 options if your cat becomes sick while boarding.* This field is required.
I authorize the attending veterinarian to administer treatment and perform diagnostic testing as is considered medically necessary. I also consent to the administration of such anesthetics or sedatives and surgical procedures ONLY if deemed to be an emergency by the attending veterinarian. I understand The Animal Medical Clinic will make every attempt to contact me prior to treatment should medical and/or surgical care of an emergency nature be required.
I only authorize basic treatment (medications such as anti-diarrheal or pain medications) as necessary to keep my pet comfortable until I can be contacted. I understand The Animal Medical Clinic will make every attempt to contact me should my pet become ill and require treatment.
11
ALL FEES ARE REQUIRED TO BE PAID IN FULL UPON COMPLETION OF THE VISIT.
In the event any balance due hereunder is not paid as agreed, the undersigned jointly and severally agree to pay all costs included in said unpaid balance, including a reasonable collection and/or attorney's fees.
12
Signature* This field is required.
Clear
Should be Empty: