Family Animal Care of Salina -- 555 E. North Street -- Salina, KS 67401 -- (785) 825-7555
Owner Information
Name:Mailing Address:
City: State: Zip:
Phone Number: Email Address:
Cell Phone Number: Accept Text/Picture Messages?: YES NO
Driver’s License Number:
Emergency Contact Information
By providing the information below, you are authorizing this person to make decisions regarding the care of your pet in case of an emergency when the primary owner listed above cannot be contacted.
Name:Address: City/State/Zip:
Phone Number: Cell Phone Number:
Date
Pet Information#1:
Name: DOG / CAT / OTHER (please circle one)Breed: Age:
Color/Markings: MALE / FEMALE
Is your pet spayed/neutered? YES / NO
Has this pet ever had any of the following issues? Please circle and explain below.
Aggression towards dogs
or people / Escape from fencing, cages, or enclosures / Anxiety (thunderstorm, noises, etc…) / Seizures / Major Medical Condition / Digging,
Destruction,
Chewing / Allergies
or
Drug Sensitivity / Other
Please list feeding instructions, including type of food and amount.
Does this pet require any medication during their stay? YES / NO
Please list medications and dosing instructions:
- If you have more than one pet, please continue on the back.
Pet InformationPet 2:
Name: DOG / CAT / OTHER (please circle one)Breed: Age:
Color/Markings: MALE / FEMALE
Is your pet spayed/neutered? YES / NO
Has this pet ever had any of the following issues? Please circle and explain below.
Aggression towards dogs
or people / Escape from fencing, cages, or enclosures / Anxiety (thunderstorm, noises, etc…) / Seizures / Major Medical Condition / Digging, Destruction, Chewing / Allergies or Drug Sensitivity / Other
Please list feeding instructions, including type of food and amount.
Does this pet require any medication during their stay? YES / NO
Please list medications and dosing instructions:
Pet 3:
Name: DOG / CAT / OTHER (please circle one)Breed: Age:
Color/Markings: MALE / FEMALE
Is your pet spayed/neutered? YES / NO
Has this pet ever had any of the following issues? Please circle and explain below.
Aggression towards dogs
or people / Escape from fencing, cages, or enclosures / Anxiety (thunderstorms, noises, etc…) / Seizures / Major Medical Condition / Digging, Destruction, Chewing / Allergies or Drug Sensitivity / Other
Please list feeding instructions, including type of food and amount.
Does this pet require any medication during their stay? YES / NO
Please list medications and dosing instructions:
BOARDING AGREEMENT
OWNER:______
DATE: ______ /
Boarding Kennels
555 E. North Street – (785) 825-7555
This is a contract between Family Animal Care of Salina (FACS) and pet owner. The kennel agrees to exercise due and reasonable care, and to keep the kennel premises sanitary and properly enclosed. The animal is to be fed properly and regularly and be housed in clean and safe quarters. All animals are boarded or are otherwise handled or cared for by kennel or hospital staff.
Please read carefully and initial the following:
______RATES: The rate for kenneling is $15.00 per night, per pet. All boarding fees will be collected at drop-off. By request only, you may board more than one dog in a single run dependent on availability and limited to 160 pounds of total weight per run. Boarding more than one dog in a single kennel does not change the boarding rate.
______PICK-UP/ DROP OFF HOURS are listed below. There will be NO after hour’s pick-up or drop-off times available.All pets brought into and out of the kennel must be on a leash or in a carrier and under the owners control until staff takes charge of your pet.
Monday – Friday: 8 a.m. to 5:30 p.m, Saturday: 8 a.m. to noon, Sunday: 3 pm to 5 pm (pick up only)
______CONTACT INFORMATION: Owners are responsible for maintaining updated contact information, emergency contact information, and pet information.
______FOOD: Owners will provide enough food and feeding instructions to feed animal for the duration of their stay. If Family Animal Care is required to provide additional food, owners will be responsible for any additional charges at time of pick-up.
______BEDDING/TOYS: FAC will provide bedding for all animals. FACS cannot be responsible for any bedding, toys, or accessories brought from home. Toys found to be in disrepair will be immediately removed from kennel and properly disposed of. FACS is not responsible for any medical issues arising from ingestion/ misuse of items provided by owner. If bedding becomes soiled, it will be removed from the kennel and bagged to be returned to owner. FAC will not be responsible for laundering personal bedding.
Continue on back
______MEDICAL CARE: Family Animal Care will provide any medical care that is required. FACS will attempt to contact the primary owner and/or the emergency contact person as listed on the boarding reservation form prior to medical treatment. In case of an emergency requiring immediate care or if permission cannot be obtained from the primary/emergency contact, medical treatment will be provided at the discretion of hospital and kennel staff. Any medical costs or damages incurred by your pet will be the responsibility of the pet owner and will be paid in full at time of pick-up.
______FLEAS: We highly recommend that your pet be on a flea preventative prior to being boarded. Although we take every precaution to prevent fleas, the best protection for your pet is a regular preventative schedule as directed by your veterinarian. FACS will not be responsible for flea treatments if fleas are contracted during your stay. If your pet is found to have fleas while boarding he/she will AUTOMATICALLY receive a topical or oral flea treatment at the discretion of hospital staff. Owners are responsible for this charge up to $20 per pet.
______BATHING: Due to the active nature of the boarding kennel, pets may require bathing after their stay at the kennel. This service is offered at an additional fee of $20/ pet. There are a limited number of spots available on a first come first served basis. Owner accepts responsibility for any grooming that may be required following a kennel stay.
______All charges incurred by owner shall be payable upon pick-up of pet. FACS shall have, and is hereby granted, a lien on the pet for any and all unpaid charges resulting from services provided by kennel. The Owner hereby agrees that in the event the charges are not paid when due, in accordance with this contract, or pet is not picked up within ten days of scheduled pick-up, Kennel may exercise its lien rights upon ten days’ written notice given by Kennel to Owner, by Certified Mail, to address shown on contract. Owner shall remain liable to Kennel for the unpaid balance.
There will be no liability on the kennel’s part for loss or damage due to disease, theft, fire, death, escape, injury or harm to persons, other dogs or property of said dogs/owners, or unavoidable causes provided diligence and care having been exercised. Reasonableand responsible care is taken when dogs are released into the exercise yards. Family Animal Care will not be liable for injury. FACS will not take responsibility for any female in heat. Owner further agrees that any legal costs, as a result of unpaid or disputed funds, incurred by FACS for the owner of said animal(s) shall be paid by the owner to FACS. If FACS is found liable for any kind of negligence we will only be held liable for a maximum of $100.00 in damage no matter what the circumstances are including being found liable in a court of law. This contract contains the entire agreement between the parties and supersedes and replaces any prior agreement - written or verbal. By signing this contract Owner agrees to the terms and conditions stated herewith.
______
SignatureDate
Revised January 13, 2016