Pet Vaccine History
Please fill in blanks with either: Date Administered Last OR if past due, write: Update Today
For the protection of your pet/pets the following vaccinations are required
Dogs must have Rabies, DHLPP and Bordetella
Cats must be up to date on Rabies and FVRCPC
Note: All animals will be given CapStar at the cost of $15.00 (Does not prevent fleas but kills any fleas that are currently on the
I understand you cannot guarantee the health my animal. I understand and will not hold the clinic responsible for
conditions that are unavoidable in boarding kennels, such as but not limited to weight loss, hair loss, upper respiratory
infections, bronchitis, diarrhea, and fleas. I understand all pets admitted to the clinic must be protected against
communicable contagious diseases and must be free of internal and external parasites or will be treated on entry or
discovery at the owner’s expense.
If vaccinations were performed elsewhere, I can provide written documentation of the Rabies vaccination administered
by a licensed veterinarian within 24 hours of notification to do so in the event my animal should bite any person or other
pet while on the clinic premise.
I understand that in the event of my animal’s illness, the staff will immediately attempt to contact me or my agent to
discuss the problem and treatment options, but may not be able to contact me immediately and is therefore authorized
to initiate appropriate treatment until myself or my agent can be reached. Should an EMERGENCY arise, I authorize the
medical staff to sedate my animal and or perform such emergency procedures as may be necessary for the health of my
animal until I can be notified. I agree to pay, in full, all charges for necessary services rendered for and to my animal.
I understand that the clinic is not responsible for loss or damage to personal items left with the pet including but not
limited to leashes, collars, toys and bedding.
The clinic is to use all reasonable precaution against injury, escape or death of my animal. The clinic and staff will not be
held liable for any problems that develop provided reasonable care and precautions are followed. I understand that any
problem that develops with my animal will be treated as noted above and I assume full responsibility for the treatment