Animal Intake Form in Rio Rancho, NM

Contact Information

Owner:

Home phone/Cell phone:

Address:

Street Address City State / Province / Region ZIP / Postal Code

I approve the use of my animals’ picture for promotional purposes:

Yes
No

Email address:

Veterinary Clinic:

Phone:

Emergency Contact:

Phone:

How did you hear about us?

Pet Information

Name of Pet:

DOB:

Breed:

Color:

Weight:

Sex

Female
Male
Spayed Female
Neutered Male

Medical Problems:

Restrictions, Food allergies, Fears:

What is your pets current diet/food brand?

Dry
Wet

Explain Dry Diet

Amount: (Dry)

Frequency: (Dry)

Explain Wet Diet

Amount: (wet)

Frequency: (wet)

Is your pet on medications or supplements currently? (Note this includes any over the counter medications) If yes, please fill in the table below :

Yes
No

Medication Name

Dosage

Directions

Past Socialization:

Please Click or Mark below button to add more pet information

Add Additional Pet

Pet Information

Name of Pet:

DOB:

Breed:

Color:

Weight:

Sex:

Female
Male
Spayed
Neutered

Medical Problems:

Restrictions, Food allergies, Fears:

What is your pets current diet/food brand?

Dry
Wet

Explain Dry Diet

Amount: (Dry)

Frequency: (Dry)

Explain Wet Diet

Amount: (wet)

Frequency: (wet)

Is your pet on medications or supplements currently? (Note this includes any over the counter medications) If yes, please fill in the table below :

Yes
No

Medication Name

Dosage

Directions

Past Socialization:

Please Click or Mark below button to add more pet information

Add More

Pet Information

Name of Pet:

DOB:

Breed:

Color:

Weight:

Sex:

Female
Male
Spayed
Neutered

Medical Problems:

Restrictions, Food allergies, Fears:

What is your pets current diet/food brand?

Dry
Wet

explain dry diet

Amount:(dry)

Frequency:(dry)

explain wet diet

Amount:(wet)

Frequency:(wet)

Is your pet on medications or supplements currently? (Note this includes any over the counter medications) If yes, please fill in the table below :

Yes
No

Medication Name

Dosage

Directions

Past Socialization:

Deposit and Cancellation Policy:

Holiday boarding reservations require a 20% down deposit at the time the reservation is made. If you need to cancel your boarding stay, please give notice of cancellation seven days prior to your day of drop off. We can refund your deposit or use it as a credit for another stay.

I have read and understand the deposit and cancellation policy

Socialization for Dogs(please initial)

All dogs allowed to socialize with other dogs are carefully monitored and never left unsupervised. There are risks involved with allowing animals to socialize with one another including fights, illnesses and injuries. However, we at Monte Vista Pet Lodge LLC take careful measures to minimize the possibility of those risks.By giving us the permission to allow your pet to socialize in our facility you understand the risks involved as stated above, and you agree to the following statement:

I, the owner of the pet indicated on the contract, acknowledges that all rights to claims and liabilities against Monte Vista Pet Lodge LLC are relinquished by myself for or attributable to any injury or illness involving my pet. I also understand that Monte Vista Pet Lodge LLC technicians have the right to assess and change the status of my pet’s socialization at any time.

Yes, I would like my dog to be able to socialize with other dogs on the property.
No, I would not like my dog to socialize with other dogs on the property

Owner Release Form

Please read, carefully, and initial each item.

Owner agrees to pay all fees and charges for services rendered upon departure of the pet from the property. Owner understands and agrees that the pet shall not leave the property until all charges are paid in full by the owner. Owner is aware of the consequences of an extended pick-up date and time and accepts the additional daily charges incurred.
Owner understands that Monte Vista Pet Lodge LLC is not an animal clinic or hospital of any kind and does not board any animal considered physiologically unstable. All animals in critical condition are recommended to receive treatment from an animal hospital or clinic. Monte Vista Pet Lodge LLC does not diagnose or treat medical conditions of any animal under any circumstance.
Owner agrees that Owner is solely responsible for any and all actions and behaviors engaged in by pet while a guest at Monte Vista Pet Lodge LLC, including any and all damage to recovery and boarding structures and/or property, including personal property brought in by owner.
Owner agrees that Monte Vista Pet Lodge is not responsible for lost items brought in by owner.
Owner acknowledges that pet has been vaccinated up to current standards for pet. Dog Vaccines: Rabies, Distemper/ Para Parvo, Bordetella, and Flea/ Tick Prevention (April – October) Cat Vaccines: Rabies, FVRCP, and Flea/ Tick Prevention (April – October)
Owner understands that Monte Vista Pet Lodge LLC has the right to refuse service to anyone. Monte Vista Pet Lodge LLC does not board animals with behavioral problems that are deemed a safety risk to staff, other boarders, or your own pet. Though we are a well animal boarding facility, in the event veterinary care is needed, we will immediately have your loved one seen at Zia Animal Hospital.
Owner authorizes staff members to transport pet to Zia Animal Hospital in case of emergency. Owner or emergency contact will be called at time of transport of pet.

I (Owner)

give Zia Animal Hospital permission to treat my pet(s)

in case of emergency

Please initial one:

please provide whatever treatment is necessary for the care of my pet as determined by the attending veterinarian at Zia Animal Hospital
provide treatment for my pet not to exceed $

$

Please initial

I agree to be responsible for all fees and charges associated with the above determined treatment of my pet
I authorize Monte Vista Pet Lodge LLC as representative in my absence to sign medical care/treatment authorization forms for my pet
I understand payments to Monte Vista Pet Lodge LLC must be made prior to animals discharge.

General (please initial) Domestic animals housed at the Monte Vista Pet Lodge are discharged in one of following ways:

Returned to Owner

Only after the owner has paid for services and shown proper identification, the animal will be brought to them on a leash or in a carrier depending on the species and size of the animal.

Transfer to the Animal Shelter

If someone does not claim an animal after the following three situations combined: 1) the required pick up date 2) two phone calls to the owner with a certified letter or 3) there is lacking proof of ownership; the animal will be transferred to the local animal shelter as an “owner abandoned” animal.I understand the policy regarding animal discharge.

By signing below I acknowledge that I have read and agree to the terms and conditions of this contract as stated above.

Owner Signature:

Date:

Please note any additional information or instruction: