Please note: We will be closed on Friday, June 19th from 8:30am-10:30am for our monthly staff meeting and training.

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Lodging Information Form

Annual Lodging Information Form

This field is for validation purposes and should be left unchanged.

Country Friends would like to welcome your four-legged family members to our lodging care. We provide a safe and loving environment with comfortable and open lodging spaces. Please read CFVC's General Lodging Rules, Lodging information (including the Texas Required Notice Section 824.003), and sign/date where necessary. Note: All fields are required to proceed to the next section.

Today's Date(Required)

Client Name(Required)

First Last

Best Email for Immediate Contact(Required)

Best Phone Number for Immediate Contact(Required)

Check-In Date (Mon-Fri 7 am - 5:30 pm) CFVC is closed to the public on Saturdays/Sundays.(Required)

Check-Out Date (Mon-Fri 7 am - 5:30 pm) CFVC is closed to the public on Saturdays/Sundays.(Required)

General Lodging Information

1. Both for check-in and check-out, please arrive between 7 am and 5:30 pm, Monday-Friday. We are closed 12:30 pm - 2 pm for administrative time and lunch and both Saturday and Sunday.

a. Please plan on 15 - 30 minutes for the check-in and check-out process with an Animal Care Attendant (ACA) as we may be assisting another client and/or pet.

b. This allows for any time needed to exchange food and any medications.

c. An ACA will review the information on this lodging form with you and may have follow-up questions. This is a good time for clients to ask questions, too.

2. Please consider different lodging options for female dogs that are in estrus (in heat) due to the nature of your pet's comfort and sense of security.

3. Lodging Care Information

a. CFVC requires that all aggressive behaviors are reported at the time of check-in. Does your pet have triggers and or aggressive behaviors to be aware of?

a. CFVC requires that all aggressive behaviors are reported at the time of check-in. Does your pet have triggers and or aggressive behaviors to be aware of?(Required)

Yes

If yes, please list:(Required)

b. Does your pet have a history of chewing/shredding blankets/mats/beds?

Yes

c. Please bring your pet's food, measured appropriately for the length of stay. We provide food and water dishes.

d. It is best to keep your pet on his/her normal diet. However; CFVC does offer Purina's EN diet. The charge p/EN can is $3.06 (Feline) and $4.45 (Canine). Food pricing is subject to change if our supplier increases the cost. The client is financially responsible for all additional charges.

e. CFVC does have other canned food available (chicken) and soft foods if needed. These foods, too, will have additional charges that you, the client, will be responsible for.

f. All boarding spaces are located indoors with centralized heating and air. Our grass yard is completely fenced for your pet's protection. Country Friends Veterinary Clinic staff will use professional judgement to determine if your pet can be let off leash in our yard during his/her daily exercise. All dogs are walked outside three times daily, Monday - Friday and twice Sat/Sun. Your pet will never be in a yard unsupervised.

g. All boarding spaces are cleaned and sanitized each day. Pets are provided fresh/clean bedding as necessary.

h. All pets will always have fresh water available.

j. Although we diligently walk all pets on a slip leash, please be aware that given the unpredictable nature of dogs, an interaction could take place between animals and unforeseen events could occur while on scheduled walks. If such an event results in injury to your pet, to other pets, or to other people, you, as the pet's owner will be financially responsible for such an injury.

i. Prior arrangements must be made for family pets to stay together in the same lodging space.

Pets that require separation at meal times cannot board in the same lodging space
Please call and inquire on available space. Pets must be listed under the same account and family name in our records
CFVC reserves the right to immediately change your pet's shared boarding space if we believe it is necessary to protect the health and well-being of your pets and or staff. The required use of a separate lodging space will incur additional charges.

I, the client, acknowledge that I have received, understand, and I willingly comply with CFVC's lodging general information and care policies, including client responsibilities that may include additional charges:(Required)

General Lodging Rules

We require that all lodging pets be fully vaccinated for the safety and protection of both pets and people. If your pet has not been examined by a Country Friends veterinarian, or if your pet obtained vaccinations elsewhere, we require proper medical documentation for the following:

DOGS:

Rabies: administered within 1-3 years prior to boarding (variation protocols put in place by a licensed veterinarian will be accepted).
Bordetella (for Kennel Cough): administered within 12 months.
DHPP or DHPPL: administered within 12 months (exceptions: autoimmune and pediatric pets with veterinarian documentation and supporting records must be provided prior to or at the time of check-in).

CATS:

Rabies: administered within 12 months prior to boarding (variation protocols put in place by a licensed veterinarian will be accepted).
FVRCP: administered within 1-3 years prior to boarding (variation protocols put in place by a licensed veterinarian will be accepted).

Puppies and Kittens:

If you choose to lodge a young pet who has not completed all sets of doctor recommended vaccines you are doing so knowing that young pets are at a higher risk of contracting contagious diseases, despite CFVC's best efforts to prevent this occurrence.

Elderly Pets:

If you choose to lodge an elderly pet whose vaccines have been suspended due to doctor recommendation you are doing so knowing that your pet is at a higher risk of contracting contagious diseases, despite CFVC's best efforts to prevent this occurrence.

Parasite Information:

Lodging pets that have evidence and/or the presence of external parasites (fleas and ticks) and/or internal parasites (hookworms/roundworms/tapeworms) will require a veterinary exam and doctor recommended treatment, at the client's expense.

Financial Information:

All pets must arrive to check-in with the proper vaccine records for each pet lodging with us. Records must show compliance with the CFVC vaccination lodging policy. Without documentation, pets will require a veterinary exam and all required vaccinations at the client's expense.

Save time at check-in by sending your pet's records (before you arrive) to CFVC's email: general@cfvc.net

I, the client, acknowledge that I have received, understand, and willingly comply with CFVC's lodging vaccine and parasite policies including client responsibilities that may incur additional charges.(Required)

Texas Law (Sec 801.357):

Please notify CFVC if you need to extend the lodging care date. Any pet who is lodging beyond the contracted date will continue to be cared for. All additional expenses incurred are the client's responsibility.
Without proper advance communication, any pet left for a period of more than 10 days beyond the scheduled period for which Country Friends Veterinary Clinic services are contracted will be considered abandoned. Necessary steps will be taken to turn the animal over to the proper authorities.

I, the client, acknowledge that I have received, understand, and that I willingly comply with CFVC's extended stay policy and the state of Texas abandonment policy, including client responsibilities that may incur additional charges.(Required)

Medication Administration:

Pets that require administration of one or more prescribed medications will incur one administration charge for each lodging pet on each day the medications are administered ($10 per day, pricing subject to change).
Any over the counter and or prescribed medications for your pet should be brought in their original container(s).
Your pet will receive interaction, observation, with daily documented notes.
If your pet has new and or previously undocumented symptoms of an illness orcondition, a veterinarian will assess your pet's condition.
If needed, your pet will receive medical care and CFVC will attempt to reach you prior if possible.
Necessary medical treatment will incur additional charges. These medical charges will be added onto your lodging estimate.

I, the client, acknowledge that I have received, understand, and I willingly comply with CFVC's Medication Administration policies including client responsibilities that may include additional charges.(Required)

Treatment Authorization(Required)

If I am unable to be reached, I AUTHORIZE CFVC to provide necessary medical treatment and or emergency care. If you choose "yes" an additional section will be provided with more information.

If I am unable to be reached, I DO NOT AUTHORIZE CFVC to to provide necessary medical treatment and or emergency care during my pet's stay.

Your signature is required to deny emergency care authorization:(Required)

Emergency contact information is required and must be provided to Country Friends Veterinary Clinic's staff for your pet's stay. If we are unable to reach you or your emergency contacts during an emergency, we will reference your pet's lifesaving emergency directive that is discussed at each check-in and documented on your pet's Treatment Plan.

My emergency contact's first and last name:(Required)

First Last

My emergency contact's phone number:(Required)

Please acknowledge that you have received, understand, and you (the client) willingly comply with CFVC's emergency contact policy.(Required)

By signing below I (the client) have read, understand, and I willingly agree to all the above outlined rules some of which include unforeseen services and or treatment that will likely incur additional charges. FULL payment for ALL services, products, prescriptions, and procedure(s) on (or not on) the signed Treatment plan is due on the date and at the time of the lodging pet's release.(Required)

REQUIRED NOTICE TO ALL CLIENTS: LACK OF FIRE SUPPRESSION AND OVERNIGHT STAFFING

Country Friends Veterinary Clinic (the "Facility"), as is allowed by Texas law, is not equipped with an on-site fire suppression sprinkler system and does not routinely employ on-site personnel during the hours of 7 pm - 6:30 am. All animals boarded at the Facility may be left unattended during those times. HOWEVER, THE FACILITY DOES HAVE FIRE AND SECURITY SYSTEMS THAT ARE MONITORED AND CONNECTED TO THE LOCAL FIRE DEPARTMENT. Throughout the hospital and lodging area we are equipped with fire extinguishers. These extinguishers are inspected by the fire marshal as required by law.(Required)

You agree to release, indemnify, and agree to hold Country Friends Veterinary Clinic harmless from any and all manner of damages, claims, Ioss, liabilities, cost or expense, cause of actions or suits, whatsoever in law or equity, (including without limitation attorney's fees and related costs) arising out of or related to the services provided by Country Friends Veterinary Clinic (I) inaccuracy in any statement made by yourself or information provided by you to Country Friends Veterinary Clinic, (II) your pet, including but not limited to destruction of property, dog bites, injury, and transmission of disease, and (III) any action by yourself which is in breach of the terms and conditions of this agreement. My signature below affirms that I have read, understand, and willingly agree to all of the outlined general lodging information and the required notice as stated above.(Required)

Date(Required)

Pet Information

Please provide the following details so that we can provide desired accommodations.

Pet's Name (if you have more than one lodging pet enter the first pet's name):(Required)

Is your pet currently on any medications aside from prevention?(Required)

Yes

If YES, what over the counter and or prescription medications are required and how often are they administered?(Required)

Describe your pet's meal schedule and the amount of food that you feed your pet?(Required)

My pet has food allergies:(Required)

Yes

If YES, please provide details of the food allergies:(Required)

If scheduling permits, would you like for your pet to have a bath during their stay?(Required)

Yes

If NO, would you like a nail trim, anal gland expression, or ear cleaning instead?(Required)

Yes

If YES, please enter the service you would like for us to provide:(Required)

Do you have another pet(s) to board?(Required)

Yes

Second Pet's Name:(Required)

Is your pet currently on any medications aside from prevention?(Required)

Yes

If YES, what over the counter and or prescription medications are required and how often are they administered?(Required)

Describe your pet's meal schedule and the amount of food that you feed your pet?(Required)

My pet has food allergies:(Required)

Yes

If YES, please provide details of the food allergies:(Required)

If scheduling permits, would you like for your pet to have a bath during their stay?(Required)

Yes

If NO, would you like a nail trim, anal gland expression, or ear cleaning instead?(Required)

Yes

If YES, please enter the service you would like for us to provide:(Required)

Do you have another pet(s) to board?(Required)

Yes

Third Pet's Name:(Required)

Is your pet currently on any medications aside from prevention?(Required)

Yes

If YES, what over the counter and or prescription medications are required and how often are they administered?(Required)

Describe your pet's meal schedule and the amount of food that you feed your pet?(Required)

My pet has food allergies:(Required)

Yes

If YES, please provide details of the food allergies:(Required)

If scheduling permits, would you like for your pet to have a bath during their stay?(Required)

Yes

If NO, would you like a nail trim, anal gland expression, or ear cleaning instead?(Required)

Yes

If YES, please enter the service you would like for us to provide:(Required)

Do you have another pet(s) to board?(Required)

Yes

Fourth Pet's Name:(Required)

Is your pet currently on any medications aside from prevention?(Required)

Yes

If YES, what over the counter and or prescription medications are required and how often are they administered?(Required)

Describe your pet's meal schedule and the amount of food that you feed your pet?(Required)

My pet has food allergies:(Required)

Yes

If YES, please provide details of the food allergies:(Required)

If scheduling permits, would you like for your pet to have a bath during their stay?(Required)

Yes

If NO, would you like a nail trim, anal gland expression, or ear cleaning instead?(Required)

Yes

If YES, please enter the service you would like for us to provide:(Required)

Do you have another pet(s) to board?(Required)

Yes

Fifth Pet's Name:(Required)

Is your pet currently on any medications aside from prevention?(Required)

Yes

If YES, what over the counter and or prescription medications are required and how often are they administered?(Required)

Describe your pet's meal schedule and the amount of food that you feed your pet?(Required)

My pet has food allergies:(Required)

Yes

If YES, please provide details of the food allergies:(Required)

If scheduling permits, would you like for your pet to have a bath during their stay?(Required)

Yes

If NO, would you like a nail trim, anal gland expression, or ear cleaning instead?(Required)

Yes

If YES, please enter the service you would like for us to provide:(Required)

Country Friends Veterinary Clinic loves spending time with lodging pets. We prioritize our responsibility to care for all pets over tracking personal items- please choose to leave valued personal items at home. CFVC reserves the right to remove any item determined to be unsafe and is not responsible for the condition or return of personal items. Acknowledging these risks, will you be bringing any belongings with your lodging pet?(Required)

Yes

If YES, please list all items, in detail:(Required)

I have read and understand the lodging content contained throughout this form and willingly acknowledge full financial responsibility for the estimated lodging costs that may include additional medically necessary services and or treatment charges incurred during my pet's lodging stay. I am prepared to make full payment upon my scheduled return date. I may have a copy of this form upon request.(Required)

Date(Required)

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