Online Boarding Agreement at Countryside Vets

Name*

Email Address*

Phone Number*

Street Address*

City*

State*

Zip Code*

Emergency Contact Name*

Emergency Contact Number*

pet INformation

Name(s) of pet(s) Boarding with us:*

Date of Drop Off*

Date of Pickup*

Drop Off Time*

Please note that pets can only be dropped off or picked up during clinic hours.

Mon/Thu: 7:30am to 7pm
Tue/Wed: 7:30 am - 5:30pm
Friday: 7:30 am - 5pm
Saturday: 7:30 am - 12pm
Sunday : Closed

Monday & Thursday:
Tuesday & Wednesday:
Friday:
Saturday:
Sunday:

7:30 am - 7:00 pm
7:30 am - 5:30 pm
7:30 am - 5:00 pm
7:30 am - 12:00 pm
Closed

Please list any person(s) your pet can be released to if you cannot pick them up:

What will your pet eat during their stay?*

I'm bringing their foodPlease feed my pet the Royal Canin Diet

Meals Per Day

Cups of Food per Meal

Special instructions for feeding?

Will you be bringing any of your pets belongings?
If so, please list the items and state which pet they belong to. *

Do any of your pets require medication?*

YesNo

If you answered yes above, please state the pet's name and list the required medication

Other Special instructions?

additional services

‍Please check any additional services you would like for your pet to have while they are boarded. For feline pricing and information, please contact us at 770-788-7387

POLICIES

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.

Medical Illness Policy *
‍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:

If you selected “Perform services up to a predetermined amount”, please state the amount:

authorization

* I have read and understand this agreement. I fully intend to pick up my pet(s) on the above date. If I need to extend the length of stay, I will notify the clinic as soon as possible.

Thank you! Your submission has been received!

Oops! Something went wrong while submitting the form.

Online Patient Forms

Boarding Agreement

Phone

Email

Hours