Blue Ribbon Pets

General and Medical Release
Admission Policies
Effective July 2010

 

Pet Owner Name _____________________________________ Ph ________________________

Spouse _____________________________________________ Ph ________________________

Physical Address ______________________________________ Ph _______________________

Mailing Address _______________________________________ Ph _______________________  

Email Address ________________________________________ Ph ________________________

 

Emergency Contact (not yourself, not your veterinarian, but someone we or your vet can call in case of emergency or other nessessary care that can authorize such care for your pet if we cannot locate you)
_____________________________________________ Ph ________________________

_____________________________________________ Ph ________________________

My pet(s) veterinarian is _____________________________________________________

 

Emergency Care:

  • I am the owner (or authorized agent of the owner) of the pet(s) provided for care to this facility. Until I or my emergency contact can be located do hereby authorize Blue Ribbon Pets (or its agents) to seek and provide medical care for my pet(s) up to the maximum of:
    _______Exam/Emerg. Fee   _______$500  _______$1000   _______Any Amt.
  • I authorize sedation if needed for examination and/or treatment

Finances:

  • I further agree to pay all  charges incurred on behalf of my pet(s) and agree that such charges must be paid in full before my pet(s) can be released to me or my agent. Should Blue Ribbon Pets choose to release my pet(s) before all charges have been paid in full, I agree to pay such charges within 10 days of discharge. A lien will be placed upon my pet(s) until all charges have been paid in full. Such liens will extend to the benifit of all persons or businesses providing care to, for or on behalf of my pet(s).
  • Fees not paid in full by the date due may be sent for collection. Collection and/or processing fees will be added to the balance owing. Any discounts given will be removed and services re-billed at regular rates. Payments returned by the financial institution will be assessed bank and other fees to the extent allowed by law and may be sent for collection and/or prosecution.
  • This facility reserves the right to refuse services at any time.

Additional Fees and Charges:

  • May apply for females in heat, intact males, fence jumpers, difficult to handle pets, obese pets, pets requiring special or other nursing care, aggressive pets, pets destroying bedding, buildings, or other parts of the facility, or exessive soiling of personal areas.
  • Will apply for pets requiring transportation to the veterinarian or refilling of special diets and/or medications.
  • Will apply for anyone arriving after-hours without an appointment (minimum of $50) or disturbing the private residence.
  • A non-refundable, non-transferable deposit is required for some peak holiday bookings (ie. Thanksgiving, Christmas, New Years)

Abandoned Animals:

  • I understand that under the terms  of the California Abandoned Animal Act and/or not withstanding any oher provision of law, should my pet not be picked up as agreed, or should this facility attempt to reach me and have reason to believe I am abandoning my pet, or that I am not able to pay charges incurred for or on behalf or my pet, my pet will be considered to be immediately abandoned, all fees and or charges become immedtiately due and payable, and this facility will proceed to accordance with the terms of the Abandoned Animal Act.

Signature____________________________________________  Date____________________

  • This means my pet may ultimately be euthanized and disposed of in accordance with State Law. Fees and other charges will accrue until the final disposition of my pet. Additionally I may be charged with applicable local, county, state, and federal laws.

Vaccinations and Medical Care:

  • Pursuant to State, County, and Local laws, written proof of current rabies vaccines (or an exemption letter) is required prior to admission (tags are not considered proof of vaccination) for all dogs and cats over the age of 16 weeks.
  • Dogs are strongly recommended to be current on all other vaccines as recommended by your veterinarian (specifically DHPP, Lepto, Bordetella, and Canine Influenza).
  • Cats are strongly recommended to be current on all other vaccines as recommended by your veterinarian (specifically FVRCP and Calicivirus).
  • Vaccines should be given at least 7 days prior to admission. Owners are responsible for knowing which vaccines are recommended by the veterinarian and for making sure their pet is vaccinated in accordance with veterinarian's instructions.
  • Some pets may have side effects or show symptoms related to recent vaccinations. Any pet showing any sign or symptom of disease must immediately leave the facility until cleared by a veterinarian to return.
  • Pets may not be admitted if he/she has exhibited any signs or symptoms of injury or illness in the 14 days prior to admission (specifically sneezing, sniffing, runny eyes, coughing, vomiting, diarrhea, fever, lack of appetite, lameness, internal or external parasites) unless cleared by their veterinarian as being not contagious to others.
  • If I have not followed these policies or have intentionally mis-stated my pet's heath, I may be held financially responsible for any costs incurred by Blue Ribbon Pets or other pets in their care.
  • I authorize the attending veterinarian to discuss pertinent medical care with Blue Ribbon Pets.

General Health and Welfare:

  • I am responsible for notifying Blue Ribbon Pets of any special needs, challenges and/or concerns my pet(s) has (have) and that if I fail to inform this facility of such special needs, challenges, or concerns, I will be responsible for the outcome as well as for any additional charges or fees incurred on behalf of my pet.
  • I am responsible for providing special diets and medications in quantities sufficient to last for the length of time my pet is expected to be here plus additional in case I am delayed or feeding or medication instructions have been changed.
  • Medications must come in the original container as dispensed or prescribed by the attending veterinarian.
  • New enviroments and changes in routine and diet may aggravate underlying or undiagnosed conditions or trigger stress induced behaviors or health issues and are not indicative of poor care.
  • I state my pet is in good physical and mental health and condition and is free of any apparent signs or symptoms of untreated injuries or illness (currently under a veterinarian's care is acceptable).
  • Pets presented with any of the above conditions must have those conditions corrected prior to admission or additional charges will apply for the Blue Ribbon Pets staff to correct those conditions.

Group Play:

  • Cats are not permitted to co-mingle unless they are from the same family and are housed together.
  • Dogs authorized for group play are matched into social groups by size, age, temperment, and personality.
  • Social groups are rotated into the play yards for play time throughout the day.
  • Dogs considered to be unsuitable for (or not allowed) group play will receive outside individual time.
  • If I authorize group play, I understand my pet may get wet or dirty during normal course of play.
  • If I authorize group play, I understand that injuries may occur as a result of normal dog behavior and that I am responsible for my dog's own injuries. If however, I know or should have resonably known that my dog was temperamentally, physically, or behaviorally not suitable for group play, I will be held responsible for all injuries or damages caused by my dog.

My pet is allowed group play   YES ________________      NO ________________

Fee Schedules:

  • Current fee schedules are posted in the office
  • Boarding fees are per day AND for any portion of the day your pet is here and by weight.  ie. If your pet is dropped off today and picked up tommorow, that is two days regardless of check in or check out times.
  • Grooming fees are charged for the length of time needed to complete the groom.
  • Additional fees will apply for obese, special needs or difficult to handle pets.
  • Day Care and Training fees are posted in the office.

 

Signature __________________________________________________   Date_______________