Boarding Client Authorization Form

Please fill out this form as completely and accurately as possible.

Boarding Client Authorization Form

It’s very important that you fill out this form preferably 48 hours prior to drop off. Every time your pet boards with us, we will need a new form filled out with the correct dates. If you have more than one pet boarding with us, you will need to fill out the form for each pet boarding. We also encourage you to call us prior to pick up to process your bill before pick up.

"*" indicates required fields

Owner's Name*

First Last

Email*

Primary Phone*

Secondary Phone

Pet's Name*

Species*

Dog

Cat

Rabbit

Bird

Other

If other, please specify

Arrival Date*

Month

Day

Year

Estimated Arrival Time*

Between 8 am - 12:30 pm, Monday - Saturday

Between 2 pm - 5 pm, Monday - Friday

Pickup Date*

Month

Day

Year

Estimated Pickup Time*

Between 8 am - 12:30 pm, Monday - Saturday

Between 2 pm - 5 pm, Monday - Friday

Food Options*

Kennel food (Purina EN)

Own food (Please baggie food for each meal and label)

Feeding instructions*

At time of drop off what will pet need for a meal the remainder of that day?*

Will your pet(canine) be attending DayCare? If yes, please fill out the day play application.*

Yes

Does your pet have any allergies or MEDICAL CONDITIONS that you are aware of?*

Yes

Is your pet on any medication or supplements?*

Yes

Add another medication or supplement?*

Yes

Would you like your pet to have a nail trim while here (please know that on holidays this might be unavailable)?*

Yes

Would you like your pet to have a To Go Home Bath (includes bath, brush, nail trim, and ear cleaning) Please know this service is performed by our kennel staff and is not considered having a grooming appointment.*

Yes

If you would like your pet bathed/groomed by our groomer while boarding, please call us at 207-439-4158 to schedule it ahead of time, as grooming does book fast. If you have already scheduled the groom while boarding, please put the date, it's scheduled. If your pet is being groomed on the day of pick up, plan on picking up in the afternoon when the groomer calls that the services have been rendered.

Do you have a groom scheduled with our professional groomer during your pet's stay with us?*

Yes

Please check one of the following canine boarding choices.*

Basic Boarding (Your pet will have a minimum of 3 breaks 30-45 minutes each daily and will not be with other dogs during these times.)

Basic Boarding with Group Play (Your pet will have a minimum of 3 breaks 30-45 minutes each daily to socialize and play with other Boarding and/or DayCare dogs) Please fill out the DayCare Client Authorization Form.

DayCare Boarding (Your pet will be socializing all day with other Boarding and/or DayCare dogs with breaks as needed. Additional fees apply.) Please fill out the DayCare Client Authorization Form.

N/A feline boarding option

Has your pet had any coughing, vomiting, diarrhea, or in juries in the last month?*

Yes

Have you seen any fleas on your pet?*

Yes

Is your pet on flea and tick preventative?*

Yes

Is your pet on heart worm/intestinal parasite preventative?*

Yes

Does your pet have any belongings with him or her for boarding?

Washable blankets, toys, and special belongings are welcome as long as they pose no threat to the pet. Kittery Animal Hospital ASSUMES NO FINANCIAL RESPONSIBILITY FOR THE CONDITION OF THEIR RETURN OR LOSS.

Who should we notify if your pet becomes ill or injured?*

If the pet becomes ill other than diarrhea and requires veterinary attention, the kennel has permission to seek medical attention with one of our staff veterinarians at the owner’s expense. Owners understand they are assuming their own risk, and Kittery Animal Hospital will not be held financially responsible for any expenses incurred from injury, illness, or exposure to illness during or after a boarding stay.

Consent*

I have read and understand*

Accommodations: I hereby entrust Kittery Animal Hospital (KAH) to care for my pet(s) during his/her boarding stay. KAH will use all reasonable precautions against illness, injury, or escape of my pet, but will not be held liable or responsible in any manner whatsoever. (KAH) will provide accommodations deemed appropriate for the safety, health, and comfort of my pet(s).

Consent*

I have read and understand*

Emergency or Illness: I have provided the above phone number(s) to reach me in case of emergency, or the name and phone number(s) of an alternate contact person who is able to authorize services if I cannot be reached. In the event of an illness or emergency, KAH will attempt to contact me or my alternate contact at the phone number(s) provided; however, I understand that if I cannot be reached within a reasonable length of time, I authorize KAH to treat my pet however is deemed necessary for his/her health and well-being, and I agree to pay for any and all expenses that may be incurred.

Signature*

By submitting this form, you acknowledge that you have read and agree to our Privacy Policy.

Contact Us

It is our mission to make every client and their pet feel comfortable from the moment they walk through the door.



Address

195 State Rd. Kittery, ME 03904

}

Hours

Mon: 8:00 am - 6:00 pm
Tue: 8:00 am - 6:00 pm
Wed: 8:00 am - 5:00 pm
Thur: 8:00 am - 6:00 pm
Fri: 8:00 am - 6:00 pm
Sat: 8:00 am - 2:00 pm (Appointments Only)
Sun: Closed



Contact

P: (207) 439-4158
F: (207) 438-9155
E: [email protected]
Text Us Via PetDesk: (207) 569-3798