small dog boarding

* Indicates required field

Name *

First

Last

Address *

Phone Number *

Email *

Emergency Contact *

Emergency Contact Phone Number *

My pet is a *

Pet's Name *

Breed *

D.O.B or age *

Sex *

Is your pet up to date with vaccines? Proof of vaccines will be required. *

Vet's Name *

First

Last

Vet's Phone Number *

Please list any health issues / medications / allergies? Is your pet prone to eye or ear infections? *

Please list the brand of food you feed, how often, and the amount. If there are any dietary restrictions please list them here. *

Using the Bristol Stool Chart as a guide, choose what type best matches your pet from the drop down list below.

Select Type *

What is your grooming routine? *

Where does your pet sleep? *

Has your pet ever bitten a person or another animal? *

If yes, what were the circumstances? *

How did you hear about us? Please be specific so I can thank them. *

Marlo Hiltz promises to respectfully offer only safe, sound, and responsible care for my pet. However, I have been made aware of the risks involved with boarding, and or walking my pet, including but not limited to interactions with other pets and potential exposure to disease and parasites, such as, fleas and ticks. I hereby agree to hold Marlo Hiltz harmless of any and all claims of injury, expense costs, or damages caused by the actions of my pet while under Marlo Hiltz's care. I authorize medical care to be provided for my pet by the above named veterinarian, or an appropriate alternative determined by Marlo Hiltz in the event that my regular vet is not available or that closer care is required. I will reimburse Marlo Hiltz for any charges related to veterinary care. I authorize Marlo Hiltz to administer or seek first aid and resuscitation where deemed necessary for my pet as determined appropriate, and I agree to hold harmless for all and any results thereof. I give permission for my pets image to be used on social media. This contract is validated by your signature below and as approval for future services without additional written authorization. Please enter your full legal name. *

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