Boarding Release Form

  • Client Details

  • Patient Details

  • Date Format: MM slash DD slash YYYY

  • Boarding Details

  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
    Requested services are provided at an additional fee.

  • Instructions

  • Authorization

  • As the owner or authorized guardian of this animal, I give permission to the hospital to receive, treat, prescribe or otherwise care for the animal above as deemed necessary during its boarding stay. I understand that I must furnish a phone number(s) to reach me in case of an emergency, or provide the name and phone number(s) of an alternate contact person who is able to authorize services if I cannot be reached. In the event of an emergency, I understand that SVH will attempt to contact me at the phone number(s) that I have provided. Should injury or circumstance warrant the need for emergency service, I authorize SVH to treat my pet if deemed necessary for its health and well-being, and I agree to pay any and all expenses that may be incurred. I understand that if my pet is on medication, I will be charged accordingly for administration. I understand that if I do not bring my pet's own medication(s), I will be charged accordingly for any hospital medication used for my pet's needs. No contact with SVH for more than 30 days is considered abandonment and forfeits all ownership rights of my pet to Sheffield Veterinary Hospital.
  • Date Format: MM slash DD slash YYYY