Cat Boarding Application (New Customers & Yearly)

Cat Boarding Application

Please complete and submit one application for each cat, and we will be in touch!

Your Name*
First Last
Address*
Street Address City ZIP Code
Cell Phone*
Do you text on your cell phone?*
- Yes I text.
- No I do not text.
Home Phone (If you have one)
Email Address*
Do you check your email when you are away?*
- Yes I check my email.
- No I don't check email when I'm gone.
Upcoming boarding dates-I would like to drop the cat off on this date:*
I would like to pick the cat up on this date:*
Other than yourself, your spouse, or your vet, who would you trust with a life or death decision for your pet?*
Phone Number of Emergency Person:*
How did you hear about us?*
- Referred by a friend.
- Internet search.
- From my veterinarian.
- Saw the sign.
- Yellow Pages in the phone book.
We would love to know who referred you:*
Cat's name:*
How old is your cat?*
Please select:*
- Female Spayed
- Female Not Spayed
- Male Neutered
- Male Not Neutered
My cat is mostly:*
- an inside pet.
- an outside pet.
Approximate Weight:*
My cat:*
- Has all claws.
- Is declawed in the front.
- Is declawed on all four feet.
Have you ever boarded this cat before?*
- Yes
- No
Approximately how many times per year do you think you will need to board this cat?*
- I usually have a friend/relative take care of my pet.
- This will probably be the only time I'll need to board my pet
- Less than 5 times per year.
- 5-10 times per year.
- On an ongoing basis.
Has your cat ever bitten or attempted to bite anyone?*
- Yes
- No
Please explain, in detail, the circumstances surrounding the bite:*
Is your cat currently under vet care?*
- Yes
- No
What is he/she being treated for?*
Name of Your Current Veterinarian:*
Veterinarian's Phone Number:*
Does your cat require medication?*
- Yes
- No
How Many Different Types of Medication Daily?*
- Just one medication.
- Two different medications.
- Three or more medications.
Please list each medication, what it is used to treat, the dosage, how many times to administer daily, and how you give it to the cat (in a piece of cheese, etc.):*
Does your cat have any health problems or past injuries?*
- Yes
- No
Please explain the medical condition or injury:*
My cat meows when:*
- He wants attention.
- At loud or strange noises.
- When he is left alone.
- Rarely, if ever.
Please check all above that apply.
Has this cat ever had an accident or sprayed (urine) in the house?*
- Yes
- No
My cat shows aggression:*
- Around food.
- Other cats.
- Around strangers.
- Around children.
- In his area/territorial.
- When he is fearful.
- Never.
Please check all above that apply.
To avoid a $15 records-retrieval fee, you must mail, drop off, or fax a current copy of your vaccination records within 24 hours of submitting this application. FAX #: 1-517-541-9519*
- I will have the records faxed or drop them off within 24 hours of submitting this application..
- I will pay the extra $15.
Exact date of last Rabies vaccination from a vet:*
Exact date of last FVRCP vaccination from a vet:*
Exact date of last Leukemia vaccination from a vet:*
GENERAL TERMS: Daisy's Pet Retreat will exercise reasonable care for the safety of your pet and to keep the boarding premises safe and secure. Daisy's liability for any boarded pet will not exceed $25. Pet owner is solely responsible for any property damage or bodily injury inflicted by the boarded animal. Daisy's cannot guarantee against accidents. We will not be liable for loss or damages to pet’s belongings.*
- I have read the above statement, and I AGREE
- I have read the above statement, and I DON'T AGREE
VACCINATIONS/HEALTH: All animals must be current on vaccines for Rabies, FVRCP and Leukemia. The owner must provide to Daisy's the veterinarian records on paper for these vaccines at least 48 hours prior to boarding. (Records may be faxed to 1-517-541-9519). All animals accepted for boarding must be of free of fleas and ticks; Owner will be charged a $50 fee for any animal that is dropped off with parasites. Owner hereby represents that this pet has not been exposed to Rabies, Leukemia, Distemper, or Feline Parvo within the last 30 days.*
- I have read the above statement and I AGREE.
- I have read the above statement and I DON'T AGREE.
BOARDING REQUIREMENTS: Cats are to be dropped off in a hard-sided carrier or crate (collars and harnesses must be removed.) Owners are to provide usual food and treats. Dry food is best in large, labeled Ziplock bags. Daisy's Pet Retreat will provide scoopable litter. Owners may also bring treats and toys. All items brought in must be CLEAN, and labeled with your pet’s name. PLEASE do not bring your pet’s dishes.*
- I have read the above statement and I AGREE.
- I have read the above statement and I DON'T AGREE.
MEDICATION & TREATMENT AUTHORIZATION: Prescription medications must be provided in the original container with the veterinarian’s Instructions. It will be administered as prescribed. Daisy's is authorized by the owner to seek veterinary advice and care, including but not limited to emergency care, at their discretion and at the owner’s sole expense. Daisy's will attempt to contact the owner before obtaining this care if possible, but this document serves as full authorization to obtain veterinary care for the pet at the owner’s expense, whether or not owner has been contacted.*
- I have read the above statement and I AGREE.
- I have read the above statement and I DON'T AGREE.
PAYMENT TERMS: Owner agrees to pay current boarding price (as listed on website) and for all specialty services upon pick up. Access to pet will be denied and pet will not be released until all charges are paid in full.*
- I have read the above statement and I AGREE.
- I have read the above statement and I DON'T AGREE.
This contract shall be legal and binding for one year from the following date, and will include any and all boarding during that period. This contract contains entire agreement, and shall be binding upon heirs, administrators, personal reps or assigns of either party. Any controversy arising from this agreement will be settled by arbitration according the Michigan Arbitration Laws, with the expense of such paid by the pet owner, regardless of prevailing party. Today's date:*
ELECTRONIC SIGNATURE: The Electronic Signatures in Global and National Commerce Act (ESIGN) (Pub.L. 106-229, 14 Stat. 464, enacted June 30, 2000, 15 U.S.C. ch.96) is a United States federal law passed by the U.S. Congress to facilitate the use of electronic records and signatures in interstate and foreign commerce by ensuring the validity and legal effect of contracts entered into electronically. By entering my name below as an online electronic signature I understand that by doing this, I agree that this document has been signed and given the same legal status equivalent to a written signature.*
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Our Suites

"Young enthusiastic owners of a great kennel!" Steve Stine

"They take service to the highest level!! I would not go anywhere else". Becky Curtis

"Leaving my dog at Daisy's gives me peace of mind that she is getting the best care possible while gone." Denise Hummel

2955 Brookfield Rd., Charlotte, Michigan 48813
ph: (517)541-9520 fax: (517)541-9519
email: daisyspetretreat@gmail.com