ONLINE FORM

Boarding Agreement Form

Save time when dropping off your pet! Complete your required boarding agreement form online.

Online Forms

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Download Form

Boarding Agreement Form

Owner Information

Pet Owner Name *

Last Name

Email Address *

Phone *

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal Code

Additional Pet Owner Name

Last Name

Pet Information

Name *

Do you have a third pet to add? *YesNo

Name *

Do you have a second pet to add? *YesNo

Name *

Please read and check each section below, stating that you understand and agree to our terms.

Requirements to board:

Service Terms:

Pet Health & Behavior Terms:

Contact with Other Pets Terms:

Medication Terms:

Medications you are requesting we administer are as follows:

Medication:

How Often:

Medication:

How Often:

Medication:

How Often:

Emergency Contact:

You must provide a minimum of one adult (over the age of 18) as your representative. Your contact(s) must be someone other than the pet parents, and not be traveling with you.

In the event we cannot reach you, you authorize us to discuss your pet with the person listed below. You agree that this person shall have full and complete authority to make any and all decisions, including those related to the health of your pet, and the expenditure of funds for or on behalf of you and your pet. However, if your pet becomes ill and you cannot be reached by BAH – your representative does not have the authority to euthanize your pet to avoid a bill.

Emergency Contact Name *

Relationship to Pet or Owner *

Emergency Contact Cell Phone *

Emergency Contact Alternate Phone *

Second Emergency Contact Name *

Relationship to Pet or Owner: *

Second Emergency Contact Cell Phone *

Second Emergency Contact Alternate Phone *

Emergencies:

Drop Off/Pick Up Terms:

Personal Items Terms:

Pets not picked up on Departure Date Terms:

If you or your representative do not pick up your pet(s) at the agreed upon day/time, you hereby authorize us to continue to provide the services as set forth in this agreement at your expense. If Baseline Animal Hospital determines, at its sole discretion, that an extension of services is required, payment in full may be required prior to extending such services.

If we do not hear from you, we will attempt to contact you by telephone &/or email using the information provided, advising you that if your pet is not picked up within a reasonable time period, your pet will be deemed to be abandoned, and we will deliver the pet(s) to a third party adoption partner, animal control or other similar agency. You understand that you may lose ownership of your pet under these circumstances.

You will remain liable to us for all unpaid charges, including without limit the court costs and reasonable attorney fees incurred in the collection of charges. If you fail to pick up your pet(s) for any reason, you release Baseline Animal Hospital from all further liability and responsibility for your pet(s).

Miscellaneous Provisions Terms:

This written agreement constitutes our entire and only agreement and there ar no oral agreements or understands except as provided for in this agreement.

Your Representations to Us:

You represent to us that you are the owner of the pet(s) and that you are fully authorized to enter into the agreement. All information about you and your pet(s) are true, accurate and complete.

You represent that to the best of your knowledge, your pet(s) have not been exposed to rabies, kennel cough, distemper, parvovirus or other known illness within 30 days prior to beginning their stay with us. And, to the best of your knowledge your pet has no injury or behavior problems including aggressive or biting behavior, that have not been disclosed us.

You agree to indemnify and hold harmless, from and against all loss, damage or expense (including attorney’s fees) resulting from misrepresentations by your or your representative or resulting from your pet’s stay including, but not limited to any person claiming to be the owner of your pet and any person claiming damage or injury by your pet.

Payment of Service Terms:

You agree to pay us for the service we will be providing to your pet during the stay with us at the rates set forth at the start of the visit. Prices are subject to change without notice, and seasonal rates may apply. Rate is charged by calendar day, and payment for the stay is expected in full the day your drop off your pet(s) at Baseline Animal Hospital. Any additional fees incurred during your pets stay will be paid on the day of the pet’s departure.

Additional Services Available
for an additional cost

Veterinary Exam - $50.00

Grooming - price varies

Nail Trim - $18.00

Anal Glands - $22.00

Kennel Intake Form

If your pet refuses to eat, may we offer wet food? Blue Buffalo GI wet food is offered. *YesNO

Does this pet have any medications? *YesNO

Any history of Seizures? *YesNO

Any recent vomiting? *YesNO

Any recent diarrhea? *YesNO

Any mouth sensitivity? *YesNO

Any allergies? *YesNO

Any eye issues?RednessDryDischargeCherry Eye

Any ear issues?RednessInflamedEar DischargeYeasty Smell

Is your female pet Intact?YesNO

Does your pet have any history of Surgery? *YesNO

Would you like our Vet to perform an Exam? Exam is $50, we will call you to go over any findings or Recommended Treatment Plan and cost to treat.YesNO

Any Specific Concerns?YesNO

Would you like your pets nails trimmed? Pedicure is $18YesNO

Would you like your pets Anal glands expressed? Anal Gland Expression fee is $22YesNO

Would you like your pet Groomed before pick up? Price will be quoted on requestYesNO

ONLINE FORM

Boarding Agreement Form

Online Forms

Boarding Agreement Form

Owner Information

Pet Information

Please read and check each section below, stating that you understand and agree to our terms.

Requirements to board:

Service Terms:

Pet Health & Behavior Terms:

Contact with Other Pets Terms:

Medication Terms:

Medications you are requesting we administer are as follows:

Emergency Contact:

Emergencies:

Drop Off/Pick Up Terms:

Personal Items Terms:

Pets not picked up on Departure Date Terms:

Miscellaneous Provisions Terms:

Your Representations to Us:

Payment of Service Terms:

Kennel Intake Form

Ready to Visit?

Location

Contact Details

Hours

Pet Emergencies Handled Only During Normal Business Hours