Animal Medical Center
Animal Medical Center of Casa Grande PLLC Boarding Registration Pet Last name:
Pet First Name:
Date:
My pet is checking in on___________________ and will be staying until __________________ Phone number where I can be reached ____________________________________________ Secondary contact _________________________ Phone number________________________ _______I understand that the CHECK-OUT time for my pet is 5:00P Monday-Friday. If I am unable to pick up my pet by 5:00P Monday through Friday I will be charged another night stay or through the next business day. Vaccine/ Health assurance: Feline: 1. FVRCP vaccine, Rabies vaccine, Flea & Tick Preventative Canine: 1. DA2PP vaccine, Rabies vaccine, Bordetella vaccine, Flea & Tick Preventative _______I understand that all vaccines must have been given by a veterinarian and all Flea and Tick Preventative must be prescribed by a veterinarian. If proof cannot be provided, these treatments will be performed here at your (the owner’s) expense. Emergency situations are rare but do occur. I understand everything will be done to contact me should that occur. I also understand I will be responsible for any charges accrued at that time. Attempt ALL life-saving measures________
Do not resuscitate_________
Animal Medical Center of Casa Grande PLLC is not responsible for any lost or damaged items. Be aware stress responses from boarding can include but are not limited to: not eating, biting, vomiting, diarrhea etc. These responses may necessitate medication administration. You (the owner) will be responsible for any charges accrued for these medications.
____________________________________________________
_______________
Owner/ Guardian Signature
Date
3151 N. Piper Ave. Suite 107 Casa Grande, AZ 85122
Phone: 520-836-2166 Fax: 520-836-7067
Find us on FACEBOOK [email protected]
Pet First Name:
Date:
My pet is checking in on___________________ and will be staying until __________________ Phone number where I can be reached ____________________________________________ Secondary contact _________________________ Phone number________________________ _______I understand that the CHECK-OUT time for my pet is 5:00P Monday-Friday. If I am unable to pick up my pet by 5:00P Monday through Friday I will be charged another night stay or through the next business day. Vaccine/ Health assurance: Feline: 1. FVRCP vaccine, Rabies vaccine, Flea & Tick Preventative Canine: 1. DA2PP vaccine, Rabies vaccine, Bordetella vaccine, Flea & Tick Preventative _______I understand that all vaccines must have been given by a veterinarian and all Flea and Tick Preventative must be prescribed by a veterinarian. If proof cannot be provided, these treatments will be performed here at your (the owner’s) expense. Emergency situations are rare but do occur. I understand everything will be done to contact me should that occur. I also understand I will be responsible for any charges accrued at that time. Attempt ALL life-saving measures________
Do not resuscitate_________
Animal Medical Center of Casa Grande PLLC is not responsible for any lost or damaged items. Be aware stress responses from boarding can include but are not limited to: not eating, biting, vomiting, diarrhea etc. These responses may necessitate medication administration. You (the owner) will be responsible for any charges accrued for these medications.
____________________________________________________
_______________
Owner/ Guardian Signature
Date
3151 N. Piper Ave. Suite 107 Casa Grande, AZ 85122
Phone: 520-836-2166 Fax: 520-836-7067
Find us on FACEBOOK [email protected]
