Owner's Name *

First

Last

Owner's Email *

Owner's Phone *

I consent to receive SMS text messages from Eagle Veterinary Hospital. Msg & data rates may apply. Reply STOP to opt-out. *

Yes
No

Owner's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pet Information

Pet's Name *

Sex *

Male
Neutered Male
Female
Spayed Female

Color *

Breed *

Date of Entrance *

Date of Pick-up *

I (the owner) am placing my pet in the care of Eagle Veterinary Hospital (EVH), with the understanding that the hospital will use reasonable care to keep my pet in good health. I will not hold EVH liable and I assume all risks for the boarding and/or bathing of my pet. In the event of illness/injury, I do hereby give my consent for EVH to stabilize the condition by treatment, prescribing for, or operating upon my pet(s) as deemed necessary by the attending veterinarian until such time the owner can be contacted. I understand that EVH will make every reasonable attempt to contact myself prior to services. Any expenses incurred shall be paid promptly by the owner. Should the circumstances arise that my pet(s) remain unclaimed after the date, which I have stated as the pick-up date, I understand that an attempt to notify me will be made. Seven days after such notice the pet(s) will be considered abandoned and become the property of EVH. It is further understood that such action will not relieve me from paying all costs of services and the use of your hospital. I understand that an intestinal parasite screen, and Heartworm test (current within 1 year), and all vaccinations for dogs (Rabies, Dapp-L, Bordetella, Influenza (H3N2 and H3N8) must be current within one year (excluding Bordetella which is to be current within 6 months) for boarding and bathing. For cats, a negative Leukemia test and the following vaccinations Rabies, FVRCP must be current within one year for boarding and bathing. If these vaccinations, Leukemia test, Heartworm test, or intestinal parasite screen are not current, EVH will administer/perform them. Furthermore, I understand that EVH strives to be a “Flea Free” boarding facility. Therefore, if my pet is not currently on any flea preventative or fleas are found on my pet upon arrival, EVH will administer a flea preventative of their choosing to prevent any possible infestation of fleas during my pet’s stay and I agree to pay for the above-mentioned product or services. I also acknowledge that I have written down all illnesses, abnormalities, and special requirements that are needed for the care of my pet.

Boarding Fees: (all fees are per night stay, does not include extra services)

Canine <25 lbs: $26.25, 2nd Dog same run <25 lbs: $19.69
Canine 26-49 lbs: $31.50, 2nd Dog same run 26-49 lbs: $23.62
Canine >50 lbs: $18.90, 2nd Dog same run >50 lbs:$27.56
Feline: $18.90
Exotic: $21.00

Pet's weigh at check-in *

Special Instructions/Medical Conditions:

Authorization to Verify Vaccination Records

For the safety of my pet and others I hereby verify that all vaccinations stated above for my pet are current within 1 year. I hereby authorize Eagle Veterinary Hospital to verify these vaccinations. If these vaccinations are not current, I authorize Eagle Veterinary Hospital to administer them immediately. Please list the name of the hospital below. *

I agree (yes)
I disagree (no)

Where did your pet get the vaccines?

Owner's Signature *

Clear Signature

Date *

Emergency Contact Number *

Extra Services

Fees will apply

Extra Exercise *

Yes
No

Bath & Nail Trim *

Yes
No

Express Anal Glands *

Yes
No

Give Heartworm Prevention *

Yes
No

Give Flea Prevention *

Yes
No

Medications

Reminders

Boarding Consent Form