New Client Info & Boarding Contract

Owner Information

Name

Cell Phone

Spouse/Partner

Spouse/Partner Cell Phone

Address

Street Address

Address Line 2

City

State

Zip Code

Home Phone

Work Phone

Emergency Contact (Not Self or Spouse)

Name

Cell Phone

Preferred Vet Clinic

Name

Street Address

Address Line 2

City

State

Consent

I authorize my vet to fax updated vaccination records as necessary & give consent for my pet’s vet to discuss my pets care if such need should arise.

Please bring (or fax) a copy of vaccination records with you on or prior to 1st visit.

Special Plan?

Purina Proplan is included in your pet’s stay. If you prefer to bring your own food, or your pet has a special dietary requirement, please pre-portion each meal in ziplock bags marked as follows:

Name
Date
AM/PM

*$3 charge for special feed/additional feeding.

Pet 1 Information

Name

Breed

Weight

Color

Birthdate

Sex (>6 months old must be altered)

Male Intact Male Neutered Female Intact Female Spayed

Method of flea control (required)

Does your pet have an I.D. tag? (I.D. tags are required)

Yes No

Is your pet housebroken?

Yes No

Has your dog ever been boarded or attended doggie daycare?

Yes No

Brand of feed used at home

Does your dog have special diet requirements?

Yes No

If your dog is a picky eater, can we offer our food?

Yes No

List medications to be given while boarding

Has your dog ever had kennel cough?

Yes No

Has your pet ever bitten a person or another pet?

Yes No

Has your pet ever been aggressive towards people or other pets?

Yes No

Is your pet a jumper, climber, escape artist?

Yes No

Please describe any previous surgery, injury or medical condition. List physical or medical issues (include seizures, asthmatic symptoms, pancreatitis, separation anxiety, food allergies, etc.)

Pet 1 Vaccination Records

How did you hear about Noah's?

Facebook Google Referred by

Referred by

Authorized Pickup

Consent

I authorize Noah’s B & B to release my pet to the person listed below & release Noah’s of any and all responsibility for releasing my pet to any person they believe to be authorized by me. Balance must be paid for release of pet.

Authorized Individual

Phone

Pet 2 Information

Name

Breed

Weight

Color

Birthdate

Sex (>6 months old must be altered)

Male Intact Male Neutered Female Intact Female Spayed

Method of flea control (required)

Does your pet have an I.D. tag? (I.D. tags are required)

Yes No

Is your pet housebroken?

Yes No

Has your dog ever been boarded or attended doggie daycare?

Yes No

Brand of feed used at home

Does your dog have special diet requirements?

Yes No

If your dog is a picky eater, can we offer our food?

Yes No

List medications to be given while boarding

Has your dog ever had kennel cough?

Yes No

Has your pet ever bitten a person or another pet?

Yes No

Has your pet ever been aggressive towards people or other pets?

Yes No

Is your pet a jumper, climber, escape artist?

Yes No

Please describe any previous surgery, injury or medical condition. List physical or medical issues (include seizures, asthmatic symptoms, pancreatitis, separation anxiety, food allergies, etc.)

Pet 2 Vaccination Records

Pet 3 Information (If Applicable)

Name

Breed

Weight

Color

Birthdate

Sex (>6 months old must be altered)

Male Intact Male Neutered Female Intact Female Spayed

Method of flea control (required)

Does your pet have an I.D. tag? (I.D. tags are required)

Yes No

Is your pet housebroken?

Yes No

Has your dog ever been boarded or attended doggie daycare?

Yes No

Brand of feed used at home

Does your dog have special diet requirements?

Yes No

If your dog is a picky eater, can we offer our food?

Yes No

List medications to be given while boarding

Has your dog ever had kennel cough?

Yes No

Has your pet ever bitten a person or another pet?

Yes No

Has your pet ever been aggressive towards people or other pets?

Yes No

Is your pet a jumper, climber, escape artist?

Yes No

Please describe any previous surgery, injury or medical condition. List physical or medical issues (include seizures, asthmatic symptoms, pancreatitis, separation anxiety, food allergies, etc.)

Pet 3 Vaccination Records

This is a Contract between NOAHS BED AND BISCUIT (hereinafter called "Kennel") and the pet owner whose signature appears below (hereinafter called "Owner").

Owner agrees to pay the rate for boarding in effect on the date pet is checked into the kennel & any charges incurred due to late pick up. Any pet not picked up by close of business on any given day will be assumed to be boarding that night & the reservation modified to include an additional single overnight boarding fee. No afterhours pick up.
Owner further agrees to pay all costs and charges for special services requested, and all veterinary costs for the pet during the time said pet is in the care of Kennel.
Owner further agrees that the pet shall not leave Kennel until all charges are paid to Kennel by Owner.
By signing this Contract and leaving his pet with Kennel, Owner certifies to the accuracy of all information given about said pet, and that the Kennel's liability shall in no event exceed the lesser of the current chattel value of a pet of the same species or the sum of $200 per animal boarded.
The Owner further agrees to be solely responsible for any and all acts or behavior of said pet while it is in the care of Kennel.
Owner specifically represents that he or she is the sole owner of the pet, free and clear of all liens and encumbrances.
Owner specifically represents to Kennel that the pet has not been exposed to rabies, distemper, parvo virus, feline leukemia or other contagious diseases within a thirty day period prior to boarding.
All charges incurred by Owner shall be payable upon pick-up of pet, or when billed by Kennel at the address listed on Contract. Kennel shall have, and is hereby granted, a lien on the pet for any and all unpaid charges resulting from boarding the pet at Kennel. If Owner does not pick up the pet within 15 calendar days after the day the pet was due to be picked up, the pet shall be deemed to be abandoned. The person into whose custody the pet was placed for care shall first try for a period of not less than 10 days to find a new owner for the pet, and, if unable to place the pet with a new owner, shall thereafter assign pet to a private or public sale.
If the pet becomes ill or if the state of the pet's health otherwise requires professional attention, the Kennel, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the pet, and the expenses thereof shall be paid by Owner.
This Contract contains the entire agreement between the parties. All terms and conditions of this Contract shall be binding on the heirs, administrators, personal representatives and assigns of Owner and Kennel.
Any controversy or claim arising out of or relating to this Contract, or the breach thereof, or as the result of any claim or controversy involving the alleged negligence by any party to this Contract, shall be settled by arbitration in accordance with the rules of the American Arbitration Association, and judgment upon the award rendered by an arbitrator may be entered in any Court having jurisdiction thereof. The arbitrator shall, as part of this award, determine an award to the prevailing party of the costs of such arbitration and reasonable attorney's fees of the prevailing party.
This contract shall be in force for this and all future boarding at NOAHS BED AND BISCUIT.

Pet Owner

Date

Noah’s Bed & Biscuit Representative