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Boarding Contract

Owner

Phone

Email

Patient Name

Instructions

All pets left for boarding must be current on all required vaccinations and free of fleas, and ticks, or they will be treated on admission at the owner’s expense.
If medications are necessary for treatment or handling, I give my permission to Lenoir City Animal Clinic, P.C. to administer such medications.

In the event that I cannot be reached, I authorize Lenoir City Animal Clinic, P.C. to do whatever is necessary in case of illness or an emergency situation.

In the event that I cannot be reached, I authorize Lenoir City Animal Clinic, P.C. to do whatever is necessary in case of illness or an emergency situation.
A
B
I do not authorize any treatment of my pet unless I am first contacted

Authorization

I do hereby release the Lenoir City Animal Clinic, P.C. and its staff of any responsibilities and /or liability, in the absence of gross negligence, in the event that this animal should injure itself, refuse food, become ill or die while in the hospital.
I further realize that I am responsible for payment in full for procedures and treatments listed above at the time of discharge. If I neglect to pick up the animal within 5 days of written notice, you may assume that the pet is abandoned. Abandonment does not release me from my obligation for the bill.
I further agree that in the case of non-payment, a finance charge of 1 1⁄2 % per month (18% per year) will be charged and that any collection or attorney fees will be paid by me.
Untitled checkboxes field

Emergency Phone

Signature of Pet Owner/Agent

Signature

Date