Forms should be filled out once an appointment has been made

Loomis Bed and Biscuit Inn

Feline Registration Form

Owner Information:

First (Primary)

Last name

Primary phone number

First and Last Name (Secondary)

Secondary phone number

Home Address

City

State

Zip

In case of an emergency who should we call?

Phone Number

Additional Emergency Contacts and Phone Numbers

In addition to yourself, name all who are authorized to pick up your pet(s)

LBBI HOURS:

Drop Off Times:

Mon - Sat 7-9am or 12-1pm

Sunday 12-1pm

Pick Up Times:

Mon - Sat 7-9am, 12-1pm or 4-6pm

Sunday 12-1pm or 4-6pm

Cat Information:

Cat's Name

Breed

Color

Weight (Or best guess)

Sex

Neutered / Spayed?

Birthday (Or best guess)

Veterinary Hospital

Does your cat have any medical conditions that limit their activities or movements?

We require cats to be on flea prevention. What is your cat current on (If they are not is there a medical reason they cannot be on one)

Has your cat ever bitten a person or another animal? Explain if so

In the case of the untimely death of your pet, what steps would you like us to take

Service Agreement:

Loomis Bed and Biscuit Inn (LBBI) agrees to provide day care and/or boarding for the cat(s) set forth in the registration form, and to provide other services as agreed to by and between the cat owner and LBBI at the rate agreed upon.

1) Hours: (These hours are agreed upon by the city of Loomis and CANNOT be adjusted)

Cats may be dropped off Monday through Saturday from 7 a.m. until 9 a.m. or from Noon until 1 p.m. Cats may be dropped off on Sunday from Noon until 1 p.m. Cats may be picked up Monday through Saturday from 7 a.m. until 9 a.m., Noon to 1 p.m., or 4 p.m. to 6 p.m. On Sundays, cats may only be picked up from Noon to 1 p.m. or 4 p.m. to 6 p.m.

I have read #1 agree to the terms

Initials

2) Food / Medicine:

LBBI feeds the food the owner brings for the cat. The owner will pre-package food into individual servings with cat’s name on it. A small fee will be assessed if the owner prefers LBBI to package individual meals into baggies. The owner will write the cat’s name on any cans of food. LBBI feeds twice per day unless other arrangements are made. If LBBI is to administer medicine for the cat(s), the owner will clearly label the medicine with the cat’s name and the instructions. It is important for these medications to be separate from the food (even if they are to be fed in their food) so LBBI can keep track of the medication and confirm that they have been given with each meal.

3) Health / Vaccination:

Owner represents that the cat(s) is/are in good health and have not been ill with any communicable diseases within the last thirty (30) days. Cat owner further certifies that cat(s) have all current vaccinations. LBBI will NOT accept vaccines given by private party. Vaccinations required for cats are:

• Rabies

• FVRCP (Feline Viral Rhinotracheitis, Calicivirus, Panleukopenia)

The parties understand and acknowledge that LBBI has agreed to render services as described herein based upon the cat owner’s representation that the cat is healthy and has received all required vaccinations, does not suffer from any disability, illness, behavioral characteristics or conditions which could adversely affect another cat being cared for or by LBBI.

I have read #2 and #3 and agree to the terms

Initials

4) Behavior / Damages Liability:

Cat owner agrees that LBBI shall not be liable for any loss or damage to the cat by any cause whatsoever, including but not limited to fire, theft or escape of the cat.

5) Emergencies:

In the event the cat becomes ill or injured, LBBI shall notify the cat owner. If the cat owner cannot be contacted, or has failed to instruct LBBI regarding measures to be taken, or if an emergency situation exists which requires immediate action, LBBI is authorized to engage the services of a veterinarian, or to administer medicine or give such other care for the cat that appears to be reasonably advisable.

LBBI may advance any and all costs of the cat that arise as a result of the injury or illness, including veterinary costs. Cat owner shall reimburse any such advancements immediately upon pick-up of the cat or when the services have been completed.

I have read #4 and #5 and agree to the terms

Initials

6) Payment Policies:

Payment / refunds:

Balance must be paid upon pick up, using check, cash, debit card, Discover, Visa, MasterCard or American Express.

7) Additional Charges / Services / Policies:

Medication:

LBBI will gladly administer medications, vitamins and/or supplements at an additional charge. Insulin dependent cats will be charged per injection.

Special Needs Cats:

We are happy to accommodate cats who have trouble navigating, are blind, deaf, or otherwise disabled. Please let us know if your pet is special needs so we can accommodate the best way possible for them.

Amount charged for any services, including but not limited to those listed above, may be changed at any time and become effective upon posting at LBBI.

Release of Cat: LBBI will not release cat(s) to anyone but the cat owner without the owner’s prior authorization.

I have read #6 and #7 and agree to the terms

Initials

I certify that I have read and understand the entire agreement set forth on the preceding pages and that I agree to abide by this agreement and accept all terms, conditions and statements of this agreement.

First and Last Name

Cats Name

Today's Date

Signature:

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