Sunrise Pet Lodge Boarding Form Owner Name: ______________________________________________ Phone #: _______________________________ Animal Name: _________________________________________ Breed: _________________________________ Age: __________ Weight: _________________ Sex: ______________ Color: _______________________________ Arrival Date and Time: ________________________________________ Pick-Up Date and Time: _______________________________________ Emergency Contact – Name: _____________________________________ Phone #: ____________________________ Please list any and all items you have brought for your pet. Please ensure that all items are properly labeled. *Large stuffed beds cannot be washed!* You are welcome to provide your own labeled bedding, or rent from us. (Please note: we require all medications be in their original containers, with clear dosage/administration instructions.) __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ Please let us know of ANY pre-existing medical conditions we need to be aware of (diabetes, seizures, congestive heart failure, etc. ________________________________________________________________________________________ If you would like Sunrise Pet Lodge to coordinate exams, bloodwork etc. with Casper Animal Medical Center during your pets stay, please advise your check in technician and list them here._________________________________________ _________________________________________________________________________________________________ I authorize doctors and staff at Casper Animal Medical Center (CAMC) to provide veterinary services that I have requested, and all required vaccinations. In emergency circumstances, doctors and staff are authorized to provide emergency care as needed for my pet on a continuing basis until I can be reached. I understand that my pet may be considered abandoned if Sunrise Pet Lodge has not heard from me within 7 days of expected discharge date. Sunrise Pet Lodge is authorized to dispose of my pet as best deemed, including euthanasia (putting to sleep), and I am still financially responsible for all charges accrued. I further understand that no guarantee of successful treatment has been made. I certify that I understand this release, and furthermore assume responsibility of all charges accrued. ***Boarding charges are accrued on a per-night basis. If your pet is picked up after 12:00pm (noon), there will be an additional half-day charge for that day. ***An additional charge will apply if you are unable to pick-up or drop-off your pet at the regularly scheduled times. ***Saturday AND Sunday drop off and pick up from 8-10am and 4-6pm ONLY! ***48 hour notice is required for cancellations, or you will be charged for your reserved boarding dates. Special cancellation policies apply to Holiday Boarding; please ask or see the attached sheet for details. Signature: _______________________________________________________________ Date: ____________________ Intake receptionist initials: ___________ Boarding Charges – please initial next to your selected service(s) Dogs – all dogs will have access to outdoor runs 4 times daily _____ Indoor-only kennel (2’8” x 6’): $23.00/night _____ Indoor/outdoor kennel (indoor – 2’8” x 6’, outdoor 2’8” x 10’): $28.00/night _____ Garden Creek suite (4’.10” x 7’): $50.00/night for the first pet, $25.00/night for each additional pet _____ Sunrise Vista suite (7’.4” x 7’, double occupancy): $75.00/night for the first pet, $25.00/night for each additional pet Cats – all cats will have daytime access to our play area _____ Single Condo: $15.00/night _____ Multi-Level Condo: $25.00/night Exotic Pets – kept in a private, quiet, specially ventilated and heated room _____ Exotic (anything other than a cat or dog): $15.00/night; please bring your own feed, cage, aquarium, etc. Special Cases _____ V.I.P. (diabetic animals, or others with conditions requiring intensive medical attention): $30.00/night Miscellaneous Services – please initial next to your selected service(s) ____ Bath ($18.00 – dogs up to 39#; $30.00 – dogs 40# or more) Dogs boarded 7 nights or more are bathed free of charge before they are sent home! Does not include clipping or mat removal. _____ 15 minute walk: $5.00 each; please specify frequency ________________________________________ _____ Toenail trim (by veterinary technician): $8.50 _____ Express anal glands (by veterinary technician): $20.00 Bedding Rental – you will be charged the replacement fee if the item must be discarded after your pet uses it _____ Small plush bed (12” x 17”): $2.00/night - $15.00 replacement _____ Large plush bed (28” x 43”): $4.00/night - $30.00 replacement _____ X-Large plush bed (30” x 49”): $5.00/night - $30.00 replacement _____ Small orthopedic/memory foam bed (22” x 30”): $4.00/night - $30.00 replacement _____Large orthopedic/memory foam bed (30” x 36”): $5.00/ night - $40.00 replacement ***Your total bill will be discounted 10% if you are boarding more than one pet, ***OR*** if your boarding reservation spans more than 5 nights. Diet – please let us know if you brought food for your pet, along with any special feeding instructions Feed : ________________________________________ Dry / Canned SID / BID / TID / free choice Special instructions: ___________________________________________________________________________ FOR TECHNICIAN USE Date _______ AM Ate ____ Drank ____ Urinated ____BM____ Notes _____________________________________________ PM Ate ____ Drank ____ Urinated ____BM____ ______________________________________________ _______ AM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ PM Ate____ Drank ____Urinated ____BM____` _____________________________________________ _______ AM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ PM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ _______ AM Ate ____ Drank ____ Urinated ____BM_____ _____________________________________________ PM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ _______ AM Ate ____Drank ____ Urinated ____BM____ _____________________________________________ PM Ate____ Drank ____ Urinated ____ BM____ _____________________________________________ ________AM Ate ____Drank ____Urinated ____BM____ _____________________________________________ PM Ate____ Drank____ Urinated____ BM_____ _____________________________________________ ________AM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ PM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ ________ AM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ PM Ate____ Drank ____Urinated ____BM____ _____________________________________________ ________ AM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ PM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ ________ AM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ PM Ate ____ Drank ____ Urinated ____BM____ _____________________________________________ Medications – please list the drug name, dosage, and clear administration instructions 1. 2. 3. 4. Drug __________________________________________ Drug__________________________________________ Drug__________________________________________ Drug__________________________________________ FOR TECHNICIAN USE Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ Date_______ 1. AM_____PM_____ 2. AM_____PM_____ 3. AM_____PM_____ 4. AM_____PM_____ SID SID SID SID BID BID BID BID TID TID TID TID ________________________ ________________________ ________________________ ________________________