Drop-off Information Form

All boarders must also be free from external (fleas, ticks, etc.) And intestinal (worms, etc.) Parasites, and will be appropriately medicated if needed.

Owner's Name*
First Last
Pet's Name (s)*
Phone Number (where owner can be reached in case of emergency)*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
List any services/procedures needed while boarding
Is your pet currently on medication(s)?*
- Yes
- No
If Yes, Name of medication(s)
Amount
Given how often?
Date and time last administered:
How much?
Pick-up/ drop-off Information
What day would you like to pick up your pet?
Date Format: MM slash DD slash YYYY
What time?

: HH

MM
Name of person picking up your pet (if other than you)
First Last
Is your pet on flea preventive?
- Yes
- No
If yes, name of preventive:
Date last applied
Date Format: MM slash DD slash YYYY
Release Signature*
RELEASE: I hereby authorize Fountain City Animal Hospital and its designated associates or assistants to receive, prescribe for, treat, anesthetize, or perform surgery upon my pet. I understand that pets left five (5) working days beyond the recommended dismissal date will be considered abandoned. I agree to pay for services rendered at the time my pet is discharged from the hospital, or when service is otherwise terminated. I also understand that any estimate given is based on the best information currently available, and is not a guarantee of charges. I have read and undersand the above policy, and will be responsible for all charges incurred during my pet’s stay
I agree to the boarding policies.
Today's date
Date Format: MM slash DD slash YYYY

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Monday: 7:30 am – 6 pm Tuesday: 7:30 am – 6 pm Wednesday: 7:30 am – 6 pm Thursday: 7:30 am – 6 pm Friday: 7:30 am – 6 pm Saturday: 8 am – 1 pm Sunday: Closed

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To ensure the health of every pet who stays with us, we have adopted the following boarding policy.

All boarders must be current on the following vaccines:

Dogs

Cats

Drop-off Information Form

Pick-up/ drop-off Information

Make An Appointment Today

We Love Caring For Your Pet

Hospital Hours

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