Consent and Release Form

Please complete one form for each pet staying with us
Facility Notice: Lack of Fire Suppression and Overnight Staffing
North Colony Animal Clinic, as is allowed by Texas law, is not equippped with an on-site fire suppression sprinkler system and does not employ on-site peronnel during the hours of 7pm-7:30am. All animals boarded at North Colony Animal Clinic will be left unattended during those times.
Primary Contact Name*
First Last
Primary Phone Number*
Email*
Additional Contact Name
First Last
Additional Phone Number
Patient Name*
Consent*
I, the undersigned client, hereby give my consent for my pet named above to be boarded at North Colony Animal Clinic on the following dates:
For boarding pets please fill in dates below:
Extended Stay Notice*
I agree to the Extended Stay policy.
North Colony Animal Clinic cannot guarantee the health of any animal, but pledges to provide appropriate care to all boarders. The undersigned client agrees to hold North Colony Animal Clinic harmless for conditions that are often unavoidable in boarding environments, including but not limited to, weight loss or gain, rough hair coat, upper respiratory infection, diarrhea, and fleas. The undersigned client agrees to pay for all related expenses for the above mentioned conditions and other boarding related illnesses.
Consent*
I, the undersigned client, understand the potential risks, complications, and benefits of the recommended treatment and hereby give my consent for my pet named above to receive the following service(s):
For service/treatment/procedure/surgeries
Abandonment Notice*
If pet is not picked up within 10 days of notification it will be considered abandoned and will be handled in accordance with state law, and that doing so does not relieve undersigned client of financial obligations.
Consent*
I acknowledge that I have received and read North Colony Animal Clinic's notice on its lack of fire suppression and overnight staffing. I understand and acknowledge that North Colony Animal Clinic is not equipped with an on-site fire suppression sprinkler system. I further understand and acknowledge that NOrth Colony Animal Clinic is unstaffed between the hours specified in the notice and that my pet will be left unattended during those times during their stay.
Consent*
By signing this consent form, I agree to release North Colony Animal Clinic, it's owners, employee's and agent's from any and all liabilities, claims or expenses arising from my pet's boarding stay, including but not limited to injuries, illnesses or death.
Consent*
I have read and understood the statements outlined in the notice and in this consent form and release. I voluntarily consent to my pet staying at North Colony Animal Clinic and acknowledge that I am solely responsible for any consequences that might arise during their stay.

Shop From Home

Online Pharmacy

CONTACT US

Emali: info@northcolonyanimalclinic.com
Phone: (972) 370-7277
Fax: (972) 370-0875

ADDRESS

4695 North Colony Blvd,
The Colony, TX 75056

HOURS OF OPERATION

Mon-Fri: 7:30 AM – 7:00 PM
Sat: 8:00 AM – 1:00 PM
Sun: Closed

Consent and Release Form

Consent and Release Form

Please complete one form for each pet staying with us

Facility Notice: Lack of Fire Suppression and Overnight Staffing

Shop From Home

Online Pharmacy

CONTACT US

ADDRESS

HOURS OF OPERATION