Timberland Animal Clinic                                                                               Tender loving care is always provided
 18110 SE Division Portland,  97236   503.665.1194

BOARDING RELEASE FORM

Name_____________________________Home#____________________
Address_________________________________________zip_____________
Boarding dates from____________________to_________________
           Pet Names                                    Special diet              Medications
_______________________K9   FE        YES      NO              YES   NO
_______________________K9   FE        YES      NO              YES   NO
_______________________K9   FE        YES      NO              YES   NO
Special    diet_____________________________________________________________
Medications:______________________________________________________________
Toys/blankets_____________________________________________________________
Special Instructions:

Please give my pet _________________a bath while boarding. (there is a charge)

Vaccination Policy
To prevent the spread of infectious diseases and parasites, hospitalized and boarded animals MUST be current on all vaccines and free of internal and external parasites. Documentation of vaccines is needed.
If not current or unablet to provide proof of vaccinations, I give my permission to update my pet(s) vaccinations in accordance with the above policy.
In addition we will examine your pet for fleas. If fleas are present we will treat to prevent infestation of our premises. I authorize the staff  parasite control as needed for my pet. I understand that I will be responsible for the cost thereof.

Signed: ______________________________ Date: __________________

Medical Illness Policy
One of the advantages of boarding your pet(s) at a veterinary clinic or hospital is that veterinary attention is readily available should the need arise.  If your pet(s) become ill, we will call the emergency number(s) listed below regarding your pet(s) symptoms, treatment options and estimate of additional costs .  If no one can be reached, however, please indicate your wishes below:

Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached.
I authorize up to $100_____ $200_____  $______ in medical care until someone can be reached

_______Do not administer any medical treatment until specific authorization is given.

Please contact: _______________________Phone # : _______________cell#________

Signed: _______________________________ Date: ___________