142 SW Baseline St.

Hillsboro, OR 9712

Phone: 503-648-4117

Fax 503-693-6840

BOARDING AGREEMENT

OWNER’S NAME________________________________DATE______

ADDRESS________________________________________________PHONE________

CITY_________________________                            STATE_________       ZIP______________

EMERGENCY CONTACT NUMBER WHILE YOUR PET IS BOARDING__________

PET’S NAME(S)_______________________________________PROOF OF VACCINATIONS: Dogs need DHPP-C, BORDATELLA & RABIES                                                             Cats need FVRCP-P & RABIES        If you do not have proof of vaccinations your pet will have to have the vaccines updated by the Dr. for your pet’s protection and the protection of other pets boarding.  If your pet has fleas or evidence of flea dirt a Capstar flea pill will be given by the Dr. The cost of Capstar is $5.00

IS YOUR PET EXPERIENCING ANY PROBLEMS THE DR. SHOULD EXAMINE? ___________

DO YOU WANT A FECAL SAMPLE TESTED FOR PARSITES?______________

IS YOUR PET ON A SPECIAL DIET?______________________________________

IS YOUR PET ON A MEDICATION?  HOW OFTEN IS IT GIVEN______________

IF A PROBLEM THAT IS CAUSING YOUR PET DISCOMFORT IS DISCOVERED DURING THE COMPLIMENTARY BOARDING EXAM, DO YOU WANT THE DR. TO BEGIN TREATMENT WHILE YOUR PET IS STAYING WITH US?  YES______NO________CALL FIRST_______

DATE & TIME YOU WILL PICK UP YOUR PET_______________I understand that if my pet is not picked up by 12 noon there will be a ½ day board charge added to my bill.  I understand that any problem that develops with my pet will be treated as deemed best by the Veterinarian and I assume full responsibility for the treatment expense.  I understand that Hillsboro Veterinary Clinic will try to reach me at my emergency contact number, but if my pet is in a crisis there may not be time to contact me.  I will contact the clinic if I’m not able to pick my pet up at the assigned time and rearrange a new pick up time.  I understand that my pet can only be picked up during regular clinic business hours.  I understand that if I do not return for my pet, written notice will be mailed to my address.  Five days after written notice my pet will be considered abandoned and become the property of Hillsboro Veterinary Clinic to do with, as we deem best.  Owner’s signature______________________________________________________