"*" indicates required fields

Photo Release

Family Pet Health Care

Emergency Contact Name & Phone Number (other than yourself)
Contact Name
Phone Number


Please note an anticipated time of pick up so that we may better plan your pet’s activities.
MM slash DD slash YYYY
Check-In Day
MM slash DD slash YYYY
Check-Out Day
Check-Out Time (if known)
MM slash DD slash YYYY


All our guests receive multiple outings and interactions daily. If you would like to further enrich their stay, please mark all that apply.
For Canine Guests (Please circle each appropriate answer.)
Is your pet spayed or neutered?
If yes, do we have permission to introduce your dog to other dogs for play?
Additional Services and Individual Cost for Canine & Feline Guests
Individual Play Time with a Handler-20 min activity ($10.30 Each)
Tuck In-10 min cuddle and bedtime story, while having a treat ($5.20 Each)
Massage-20 min quiet time with pressure release massage ($10.30 Each)
Gourmet Treat- Hand-prepared bedtime treat, depending on each guest’s nutritional needs ($3.10 Each)
Nature Walk-Off premises-on leash (Dogs only) ($10.30 Each)
Photos - App Members: (Be sure to turn on your app notifications.) (No Charge)

Feeding Instructions

Did you bring food?
Mix with dry?
Other Services due?
If necessary, may we offer wet food to entice appetite?


Please list medication(s) here. If you need more space, please let us know.
Medication & Instructions
Medication & Instructions
Bed Time

Please Note

Family Pet Health Care does our best to care for your pet’s belongings. However, we cannot be responsible for lost or damaged personal items. We do provide a variety of bedding, blankets and toys if you wish to leave your personal items at home.

FPHC Strives to keep a pest free environment for your pet’s safety. Therefore, we require that any intestinal parasites (e.g., hookworms, whipworms, tapeworms) or external pests (fleas and ticks) identified on your pet while boarding be treated at the owner’s expense.

FPHC will take reasonable precautions against injury, escape, or death of your pet. Any animal that may require emergency medical treatment will receive it at the discretion of Family Pet Health Care. By signing, I give my permission for Family Pet Health Care to administer necessary medical and/ or emergency treatment for my pet. I also hold Family Pet Health Care harmless, in the absence of negligence, in connection with these procedures. I further agree to take responsibility for all costs related to any treatments or procedures received by my pet while boarding with Family Pet Health Care and agree that full payment is due at time of discharge.

Before signing this document, please read all information.

MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.