Cattery Admission Form - Ellerslie Veterinary Clinic • Dogs • Cats
Transcription
Cattery Admission Form - Ellerslie Veterinary Clinic • Dogs • Cats
post: 199 Main Highway, Ellerslie Auckland 1051 phone: 09 281 3 481 email: [email protected] CATTERY ADMISSION FORM Owner’s Name: ____________________________________________________________________________________ Title: [ ] Mr [ ] Mrs [ ] Mr&Mrs [ ] Ms [ ] Dr Address of Owner: _________________________________________________________________________________ Email: ___________________________________________________________________________________________ Phone: Home _____________________ Work: ______________________ Cellphone: _______________________ If you are abroad, how can we contact you? _____________________________________________________________ Alternative Responsible Person for your cat / Emergency Contact: ___________________________________________ ____________________________________________________________ at telephone #_________________________ Your Cat’s Details: Name: ______________________________________ Breed: __________________________________________ Age: ____________________ Date of Birth: ______________________ Microchip? []Y []N Gender: [ ] Male [ ] Female Desexed? [ ] Y [ ] N Colour: _________________________ Any known health issues (present and past)? ____________________________________________________________ Arrival Date: _________________________________ Departure Date: __________________________________ Vaccinations: For all boarding guests, prior vaccination against feline infectious enteritis and feline respiratory disease is required. A current vaccination certificate (i.e. certifying that vaccination was done within the preceding 12 months) must be produced for each cat before admission. All certificates must have full details (including kitten vaccinations) or a minimum of 3 years prior history. Cats must not have had their last booster vaccination sooner than 10 days prior to admission. Desexing: We require all cats over 5 months of age, coming into the cattery, to be de-sexed. Flea and worm treatment: Flea and worm treatments must be up to date with a vet recognized product. For the benefit of all boarding cats, it is our policy to check for fleas and treat your cat if necessary. All cats in the cattery are under the supervision of a staff member. A staff member is not however, on the premises 24 hours a day. Administration costs require us to charge both for the day of arrival and the day of departure if pick up is later than 10 am. Rates include GST. Payment is due in full prior to the cat’s departure by Cash, Eftpos or Credit Card (Visa, Mastercard). Special conditions apply for Christmas and Easter. Financial Agreement: I agree that the terms of trade for services or supply are payment in full prior to the cat’s departure. I agree to be liable for any and all collection and legal costs associated with recovery of the account, if the account (or part thereof) remains outstanding for longer than 7 days. In that case there will also be an additional penalty fee of 10% charged on top of the original amount. I authorise the staff of Ellerslie Veterinary Clinic & Cattery to provide parasite control as needed for my cat. I also authorise the staff of Ellerslie Veterinary Clinic & Cattery to provide veterinary care to my cat in case of unforeseen illness or a medical emergency up to costs of $400. _________________________________________________ Signature of Client Responsible for Cat(s) _______________________________________ Date post: 199 Main Highway, Ellerslie Auckland 1051 phone: 09 281 3 481 email: [email protected] TERMS AND CONDITIONS For all boarding guests, prior vaccination against feline infectious enteritis and feline respiratory disease is required. A current vaccination certificate (i.e. certifying that vaccination was done within the preceding 12 months) must be produced for each cat before admission. All certificates must have full details (including kitten vaccinations) or a minimum of 3 years prior history. Cats must not have had their last booster vaccination sooner than 10 days prior to admission. 1) Flea and worm treatments must be up to date with a vet recognized product. For the benefit of all boarding cats, it is our policy to check for fleas and treat your cat if necessary. The Client will be charged for the product. 2) Opening hours are (for dropping off and picking up cats): Mon – Fri 8 am – 4 pm, Sat 9 am – 11 pm Sunday may be possible by arrangement 3) Charges: Standard rate Christmas / New Year (20 Dec – 10 Jan) Statutory Holidays 4) 5) 6) 7) 8) 9) 10) $ 16.00 $ 21.00 $ 19.00 Per cat / per day Per cat / per day Per cat / per day Additional charges: $ 2-4 per day for medicating cats. Additional charges for the Easter weekend of $ 10 / day. Administration costs require us to charge both for the day of arrival and the day of departure if pick-up is later than 10 am. Rates include GST. Payment is due in full prior to the cat’s departure by Cash, Eftpos or Credit Card (Visa, Mastercard). For cats staying longer than 4 weeks, monthly payments must be made. Cats will only be released to Clients when the account is paid in full. Discounted fees are available for: -> long term stays of longer than 4 weeks -> several cats from one household staying in the cattery We reserve the right to make suitable arrangements for any cat left in our care 14 days after the due collecting date if no contact is made by the owner or owner’s agent. We require all cats over 5 months of age, coming into the cattery, to be de-sexed. Clients are asked to advise staff of any health problems or special temperament issues, their cat has or had. Clients are asked to provide contact details for themselves in case of their cat getting sick or in case of an emergency. If clients cannot be contacted personally, they are asked to provide contact details of a responsible person while their cat stays in the cattery. Clients authorize the staff of Ellerslie Veterinary Clinic & Cattery to provide veterinary care to their cat in case of an unforeseen illness or a medical emergency up to costs of $400. If a cat needs veterinary attention due to a health problem while staying in the cattery and a Client would prefer another vet practice other than Ellerslie Veterinary Clinic to provide this service, the Client must advise the staff on admittance and organise transport to the designated clinic. All costs arising are to be paid by the Client on collection of their cat. Ellerslie Veterinary Clinic & Cattery reserve the right to refuse admittance to any cat that is showing symptoms of cat flu (sneezing, discharge from nose and/or eyes) or any other potentially contagious disease. Any cat showing these symptoms during their stay will be hospitalised in the Isolation Ward of Ellerslie Veterinary Clinic & Cattery. The Client will be charged hospital charges for this isolation care on collection of their cat. Ellerslie Veterinary Clinic & Cattery takes no responsibility for any lost or damaged items the Client leaves with the cat. We ask Clients to ensure the cat’s personal items are labelled permanently with the Clients’ surname. Ellerslie Veterinary Clinic & Cattery will give your cat the very best professional care and expertise. However, we accept no responsibility for any illness, injury, death or loss for any reason whatsoever. I have read the Terms and Conditions and I agree to them. _________________________________________________ _______________________________________ Signature of Client Responsible for Cat(s) Date