Boarding Consent Form Boarding Consent Form Name * Name First First Last Last Email * Phone * Patient's Name * Please note, we are not open on major holidays such as Memorial Day, Labor Day, Thanksgiving Day, and Christmas Day. We cannot schedule boarding pick ups or drop offs on these days. I am leaving my pet for boarding: From * To * If I cannot be reached in case of emergency, the below emergency contact can be contacted in my absence and can authorize permission for procedures. In the event of severe weather evacuation, either this contact or I will be REQUIRED to pick up my pet. NO PETS WILL BE ALLOWED TO REMAIN IN OUR FACILITY IN THE EVENT OF SEVERE WEATHER EVACUATION!!! Emergency Contact * Emergency Contact First First Last Last Phone * Relationship * Please select desired services to be done while boarding (fees apply) Microchipping Wing Trim Nail Trim Beak Trim Bath Dietary Conversion (Birds) 6-month Wellness Exam Annual Wellness Exam (Includes fecal analysis & bloodwork) Medication Administration ($5 per treatment/day, 2x/day = $10, 3x/day = $15) Current Diet/Medications Being also a veterinary hospital, we cannot keep any carriers or personal items to minimize introduction of any infectious agents. We will provide everything needed to keep your pet happy and healthy. You are welcome to bring a new toy or buy one from us. If my pet is found to have any condition or symptoms requiring additional veterinary care, I authorize EVC to examine, diagnose, hospitalize, and treat my pet. I realize that there will be fees charged for these services and agree to reimburse EVC for all charges incurred when payment is requested. **Reservations missed without 24 hours notice will incur a $60 fee.** In consideration of EVC accepting my pet for boarding, I hereby release, discharge and waive claims, demands, and/or actions against EVC, Its Agents, employees, officers, and insurers arising from or relating to injury, illness or death that may occur during the period of boarding. I certify that I have read, understood, and will abide by the boarding policy * I understand Signature * signature keyboard Clear Date * Captcha Submit If you are human, leave this field blank.