Carbon County Veterinary Hospital
Warner McFarland, DVM ~ Katie Flock-Huber, DVM ~ Molly Murphree, DVM
BOARDING AGREEMENT AND INFORMATION
Year: ________ Owner: _____________________________________________________Date: ____________________
Address: ______________________________________ City: _______________________ State: _____ Zip: __________
(If a PO Box, please give a street address also)
Email address: (1) ________________________________________ (2) ________________________________________
May we have your Email address? We are designing a website, www.carboncountyvet.com , and would like to keep in touch with
you.
CONTACT/ EMERGENCY PHONE NUMBERS: (1) _____________________________ (2) ____________________________
(Must provide contact numbers. Please do not leave blank.)
1. Pet Name: ________________________________ Sex: ________ Age: __________ Breed: _________________
Is your pet spayed or neutered? (circle) Y
N If not spayed, when was the last heat cycle? ______________________
2. Pet Name: ________________________________ Sex: ________ Age: __________ Breed: _________________
Is your pet spayed or neutered? (circle) Y N If not spayed, when was the last heat cycle? ______________________
3. Pet Name: ________________________________ Sex: ________ Age: __________ Breed: _________________
Is your pet spayed or neutered? (circle) Y N If not spayed, when was the last heat cycle? ______________________
Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
Total days ________
Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
Total days ________
Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
Total days ________
Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
Total days ________
Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
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Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
Total days ________
Arrival date: ____________ (circle) AM PM
Departure date: ___________ (circle) AM PM
Total days ________
Vaccines/Parasite Control: In order to board your pet(s) ALL VACCINATIONS MUST BE CURRENT (Rabies, DA2PL P/C
or CVR-C and Bordetella for dogs). If you are not a regular client of CCVH, it is your responsibility to provide
documentation that verifies current vaccinations from your regular veterinarian at least one week prior to boarding
reservation. * Vaccinations administered at home by pet owner are not accepted. If vaccinations are due before a
boarding reservation, they should be given at least 2 weeks prior to your reservation to provide the best protection. If
your pet needs vaccinations they can be done at the time of boarding but they may not have maximum protection
during their stay. This is for your pet’s protection as well as for the protection of all other animals in our hospital from
spreading infectious diseases. Physical examinations must be done prior to administration of all vaccines at the owner’s
expense. In Addition, if any fleas, ticks, or intestinal parasites are observed on the pets(s) or in the stool while boarding
he/she will be administered the appropriate medication at the owner’s expense.
Diet/Medication: We feed Eukanuba and Hills puppy and adult foods our kennel at no additional cost. We will be
pleased to feed a prescription diet or another preferred diet of your choice if you provide the food. Water will be
available at all times and will be refreshed twice a day, or as often as needed. If your pet requires medication we have
trained staff that can administer it. There is a $3.00 per day medications dispensed fee per animal for giving
medications while boarding and will be added to your bill. Medications need to be brought in their original labeled
prescription package/bottle. If necessary, we will fill or refill medication during the time your pet is boarded. Please
provide instructions if medication or special diet is required: _________________________________________________
__________________________________________________________________________________________________
__________________________________________________________________________________________________
Exercise: Your pet’s quarters will be cleaned and sanitized daily, or as often as needed. Dogs will receive two
complimentary outdoor walks per day at no additional charge. One additional walk (midday) is available for $3.00/day
per pet.
Additional walk: (circle) Y N
Boarding Risks: Carbon County Veterinary Hospital cannot guarantee the health of any animal, but we do strive to give
appropriate care and attention to all boarded pets. I understand that boarding creates a social atmosphere and certain
animal health conditions are unpredictable or unavoidable in boarding environments, including, but not limited to: overexertion, fatigue, reduced sleep, anxiety, stress and stress related illnesses, weight loss, hoarseness of voice, kennel
cough, upper respiratory infection, bronchitis, diarrhea, rough hair coat, hair loss, feather loss, feather damage, tail
injury, diarrhea, cuts and lacerations, broken nails, sore feet, tooth injury, flea or tick infestation and escape. Therefore, I
request that CCVH take all reasonable steps to prevent the development of such problems in my pet while he or she is
boarding. However, I recognize that it is not possible to avoid all risk, I agree that I will not hold CCVH responsible for any
such problems or illnesses which may arise out of my pet's stay at the hospital.
Emergency/Illness: Please be aware that some animals do experience stress-related illness, and may cause their
chronic conditions to worsen during their stay. Please be advised that any observed untreated, or worsening preexisting or chronic, health conditions that are causing discomfort will be treated by our veterinarians at our standard
rate. Should the pet(s) identified on this record become ill or experience an accident, injury, or emergency and I cannot
be reached immediately, I request that Carbon County Veterinary Hospital provide all medical/surgical treatment it
deems necessary, with fees not to exceed $ _________________. The staff at CCVH is authorized to initiate treatment
until I (or the pet’s agent) can be reached. I agree to pay all related expenses associated with the treatment of my pet
until I am available to discuss further care and related fees with the attending veterinarian.
Other Kennel Policies:
1. One full day’s board is charged for each day the animal is in our facility. This is based on when the pet is
dropped off (AM to AM or PM to PM).
2. Pets can be checked-in and checked-out during regularly scheduled hours only. We're sorry; we cannot
accommodate drop off or release of boarding pets after our regularly scheduled hours. Pets may be dropped off
or picked up during office hours Monday – Friday 8:00 a.m. until 5:30 p.m. and on weekends between 7:00 8:00 a.m. or 3:00 – 4:00 p.m. If you plan on dropping off and/or picking up your pet on the weekend all
boarding fees must be paid in advance.
3. All boarding stays that are over 7 days/nights may be subject to interim payments. We can charge by the week
on a card on file or the owner can pay for ½ of boarding in advance and the balance on check-out or if they pick
up on a weekend then the boarding must be paid in full in advance.
4. Boarding pets are not supervised 24 hours a day. Kennel attendants are present during a block of time in the
morning and again in the afternoons to interact with your pet, walk them outdoors, clean and disinfect their
kennel, feed, and refresh their water buckets.
5. Please take your collars, leashes and carriers with you when you drop off your pet. We do not take
responsibility for any of these items left with us
6. Other personal items may be left at your own risk. We are not responsible for loss or damage to a pet’s
personal items such as toys, beds and blankets. We will do our best to prevent this, but dogs may act
differently here then they do at home and may urinate/defecate on their beds or chew their toys. If your pet's
bed is unable to fit into your washer at home then please do not bring it because we will not be able to wash the
bed.
7. If you would like us to give your pet(s) a bath before you pick them up, please let us know this upon check-in.
The bath (includes complimentary nail trim) would be an additional fee of ($32.50)
8. We require that each boarding pet is healthy and has not been exposed to any known communicable disease
within the thirty-day period immediately prior to boarding and that he/she has not bitten anyone within the
past 10 days. Owner agrees to disclose to CCVH all known medical conditions and/or behavior problems, which
may affect pet’s care prior dropping off for boarding.
9. We will not board any intact female while she is in heat. This is for the protection your female dog/cat as well as
any intact male dog/cat that might also be boarding during this time.
I agree to make complete payment to Carbon County Veterinary Hospital at the time of discharge; unless I choose to
pick my pet(s) up on the weekend then I will pay boarding fees in advance. I fully attend to pick up my pet(s) on the date
specified above. If my circumstances change, I will notify CCVH in order to inform them of a new pick-up date and I will
pay in full and additional charges that occurred during that time. I also understand that, if I fail to pick up my pet within
10 days, and the hospital is not notified in writing of an alternate pick up date and/or arrangements, the pet will be
considered abandoned and may be removed from the premises according to Wyoming State Statute 33-30-215. I
further understand that this action does not in any way relieve me of paying all costs of your services, including the cost
of boarding. I certify that I have read carefully the above and foregoing Boarding Admission Agreement and that I
understand the contents and meaning of this document. I certify that I am over 18 years of age and I am the owner of
the above described pet, or the owner's legal representative, or that I am duly authorized by the owner to act as his/her
general agent to execute this document and accept its terms for this visit and subsequent visits.
 I have read the above and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
 I have read the above, made any changes and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
 I have read the above, made any changes and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
 I have read the above, made any changes and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
 I have read the above, made any changes and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
 I have read the above, made any changes and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
 I have read the above, made any changes and I am in full agreement.
Signature: ___________________________________________ Date_____________ Checked in by: ______________
11/2013
Reminders
Address Confirmed?
Contact Number?
Immunizations Current?
Is the dog, cat, or ferret on heartworm preventative?
Date of last fecal parasite exam: _______________________________
Any accident, illness, or injury in the last 30 days?
If boarding multiple pets from the same household, can they be safely housed together?
Accessories (toys, blanket, food, meds, etc.):
Yes
Yes
Yes
Yes
No
No
No: Update: _________
No
Yes No
Yes No
For The Future:
 Playtime: Your pet would be allowed into our fenced in yard off his/her leash, for 15-30
minutes ($4.00/day). **By marking “yes” you release CCVH of any and all liability
should your pet climbs over the fence or is injured while off his/her leash.** (circle) Yes
No Frequency: (circle) daily every other day

I consent to my dog being loose with other dogs and understand and accept the
consequences of this action.
I do not want my dog loose with other dogs.

 One additional walk (midday) is available for $3.00/day per pet.
Additional walk: (circle) Y N