Daycare & Boarding Intake form

This agreement shall apply to all boarding or daycare visits by your pet(s) to Waunakee Veterinary Clinic (“the facility”).

I understand that the facility’s staff are not veterinarians and must follow strict guidelines when administering medication to my pet(s). Medication will be administered according to the dosage prescribed on the medication bottle and the facility will not deviate from the
prescription. All prescriptions must be presented in the original pharmacy container and have a label that includes:

This is a required form for all Waunakee Veterinary Clinic participants receiving services.

First and foremost, the safety and well-being of your pet(s) is of the highest importance to us. Ensuring that your pet remains safe and well cared for is our first responsibility and as such we take it very seriously. We do our best to have our pet parents screen for pre-existing health conditions but some factors may be beyond our control. In the event that a pet appears ill, injured, or exhibits any other behavior that would reasonably suggest that the pet needs medical treatment (including anesthesia) while at our facility or participating in a service that we provide, it is imperative that we are immediately able to get them medical treatment. The Veterinarians at the Waunakee Veterinary clinic will be contacted first. In the case this cannot occur, we will call ahead to the veterinary offices in closest proximity geographically to our facility to ensure that they can handle the emergency. Your pet will be rushed to the closest facility available for treatment and you will be notified. We notify the owner after we have secured a medical treatment center for the pet to avoid unnecessary delays in your pet receiving emergency medical care. Our goal is to get your pet medical attention as quickly as possible and for that reason, it is a requirement that our pet parents sign this medical release form.

I understand that in the event of a medical emergency, Waunakee Veterinary Clinic has sole discretion to seek the immediate attention of a licensed veterinarian if deemed necessary for the welfare of my pet(s). I hereby authorize Waunakee Veterinary Clinic to seek medical attention at the closest available veterinary facility. I further acknowledge that I will be financially responsible for any medical treatment(s) required by my pet(s) as a result of the medical emergency while my pet(s) is/are receiving services provided by VCA Middleton, Madison Veterinary Services, or UW Veterinary School. If Waunakee Veterinary Clinic is unable to reach me or one of my authorized representatives, I approve veterinary care costs for my pet(s) up to the following amount and understand that if the necessary veterinary care exceeds this amount, additional recommended services may be postponed until contact has been established.

Additional Emergency Contacts (Authorized Representatives for Owner):

Pet Names and Descriptions

Pet Veterinarian Information:

I give full authority to the facility and the facility staff to request and retrieve veterinary medical records for my pet(s), as listed herein, and release Veterinarian from any liability for the release thereof.