In Case of illness or injury, I, the undersigned, do hereby give my consent for Dr. Barbara Wynne, or her agents to treat, prescribe for or operate on my pet(s) while they are being boarded at the facility, if I am unable to be contacted. They are to use all reasonable precautions against illness, injury or escape of my pet(s).

If I neglect to pick up my pet within 5 days of the pick up date, with no contact from me, the owner, Wynne Veterinary Clinic may assume the pet is unclaimed. Unclaimed pets will be considered abandoned and dealt with according to local and state regulations. It is understood that such action will not relieve me from paying all costs of services and boarding.

Owner:_________________________________ Pet Name:_________________________
Emergency Phone:_____________________________
Drop Off Date:____________ Pick Up Date:_______________
Drop off and pick up times are during our regular business hours:
Monday-Friday 9am to 12pm and 1:30pm to 5:30pm
Picking up pets when the office is closed will result in additional charges.

If you wish to leave personal items for your pet (i.e. leashes, toys, blankets, etc) we will make every effort to return these items to you. Please be aware that we are not responsible for lost or damaged items.

Instructions for your pet while boarding with us:

Feeding Instructions:

Special Diet:________________________________________________________
Dry____ Canned ____ Mixture of both____
Once a Day____ Twice a Day ____ Free Choice ____
Medications:________________________________ Owner Provided: Yes_____ No______
Optional Services:
Toenail Trim________
I have read and understand this consent form
I will be paying for this visit by Check_____ Cash_____ Credit Card_____