Daycare Consent FormYour Name* First Last Pet's Name*I understand that my dog will be given the opportunity to play with other dogs “off leash,” while in daycare.* YesI attest that my dog has never bitten another dog at any point in his or her life* YesI understand that in order to be admitted to daycare, my dog must be up to date on Distemper, Rabies, and Bordatella vaccines. I give consent for the staff to booster these vaccines when they are due. If your dog goes to another facility for vaccines, it is your responsibility to provide us with up to date vaccination information. If your dog is overdue with vaccines, your dog will not be allowed in daycare until everything is up to date.* YesI understand that in order to be admitted to daycare, my dog must have had a negative fecal within 6 months, a negative heartworm test within a year and must be on monthly heartworm, and flea and tick preventative.* YesI understand that in order to be admitted to daycare, my dog must have had a negative fecal within 6 months, a negative heartworm test within a year and must be on monthly heartworm, and flea and tick preventative.* YesI understand that although my dog may get muddy, AAH is only responsible to hose my dog off prior to going home.* YesIf my dog gets muddy, please bathe and charge me for a basic bath.* YesIf my dog shows aggression to other dogs, I understand that my dog may not be allowed to return to daycare.* YesI agree in case of minor stress related symptoms such as stomach upset, vomiting, loss of appetite, or minor scratches that the staff may administer the following over the counter remedies, Nutramaxx Proviable Forte, (for diarrhea), diphenhydramine, triple antibiotic cream, or Pepcid AC. The staff may administer a prescription bland diet as well. I agree to pay for all necessary fees related to administration.* YesI understand that if my pet becomes injured or sick at daycare beyond the symptoms above, I give consent for a veterinarian to diagnose and treat my dog. I agree to pay for the charges incurred while diagnosing and treating my pet.* YesI understand that dogs are unpredictable, and my dog may react in different ways that I am accustomed during daycare. This behavior is not limited to, aggression, chewing at cages, and possibly ingesting a foreign object. Although AAH makes every attempt to keep my dog safe, I understand that accidents happen. In the event of an accident, I agree to pay for any medical care that my dog may require at AAH or another animal hospital. As long as AAH was not negligent in their duties, I agree to release AAH from all financial liability related to any injury or accident that may occur while my dog is in daycare.* YesI agree to release Aqueduct Animal Hospital and its agents and employees from any and all liabilities or claim due to injury to myself, my pet, or any other property of mine, which may arise in any way out of services and/or products provided by or as a consequence of my association with Aqueduct Animal Hospital. AAH is not liable if my pet causes injury to him/herself and is not liable for stress related illness that they are not in control of. I understand that even day boarding can be stressful, and my pets may act differently in this environment than they do in their home, to the point of causing a fight between themselves.* YesSignature*Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.Δ
