Patient Forms
Waggin’ Tails

Access the downloadable version of the Client Release Form below.

Client Release Form

This form is designed to collect essential information about your pet and establish a liability waiver for their stay at Waggin’ Tails Doggie Dude Ranch and Pet Lodge. Please provide accurate details and read and sign the form.

Pet's Information

Name *

Breed *

Description *

Age *

Owner's Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Vet Contact Information

Name *

Phone *

Referral

How did you hear about us? *

Emergency Conact Info

Name *

First

Last

Phone *

By assigning this person as an alternate contact you authorize this person to make any medical decisions on your behalf, at your expense in the event that we cannot reach you. *

I/We certify to be the legal owner(s) or agent (hereafter referred to as “owner”) of the pet named above (hereafter referred to as “pet”) *

Injury and Illness

Owner understands that certain ‘activities’ that the pet may participate in, including but not limited to: doggie daycare, boarding and/or play, involve risk to pet and possible injury and illness. This includes but is not limited to:

• Exposure to parasites, viruses, and other infectious diseases passed from pet to pet or
person to pet;
• Bites, lacerations, sprains, strains, broken bones, paralysis, orthopedic injuries;
• Illness including diarrhea and vomiting, fatigue, dehydration, heatstroke, and even
death.

Owner understands that pets enrolled in daycare or boarding in the Bunkhouse Room are in an open environment where pets will freely interact and may play roughly. While Waggin’ tails takes all responsible safety measures and precautions, it is understood by owner that Waggin’ Tails will not be liable for any injury or illness to pet while pet is in our care.

Authorization of Medical Care

Owner understands that if the pet becomes ill or injured during their stay, Waggin’ Tails will make every reasonable effort to reach owner pursuant to the contact information owner has provided. However, if Waggin’ Tails is unable to reach owner in a timely manner, owner consents to appropriate medical care to the pet as deemed necessary by Fitchburg Veterinary Hospital. Owner agrees to be fully financially responsible for any and all costs incurred. *

If emergency situations occur, we will stabilize pet and contact owner as soon as possible. In the event of an emergency (please select one) *

Red Code: Offer no lifesaving interventions or drug therapies.
Yellow Code: Begin lifesaving interventions, including CPR and drug administrations as deemed necessary by the DVM.
Green Code: All possible life saving measures available including open chest CPR.

Property Loss or Damage

Owner further understands that any items/articles brought for use during boarding or daycare are owner’s sole risk. *

Photographs and Statements

Owner authorizes use of pet’s visual image(s), both in print and digital format, and statements made by owner, in newsletters, posters, and other materials, both physical and digital. *

Owner guarantees that pet is in good health (unless otherwise disclosed below) and is fully vaccinated, including Rabies, Bordetella, and DA2PP/DHPP vaccines, and flea/tick prevention at least 48 hours prior to boarding or daycare. Owner certifies that to their knowledge pet have a history of fighting or aggression and has never bitten a human or other pet (unless otherwise disclosed below).

If action at law to inequity is necessary to enforce the terms of this agreement, Waggin’ Tails Doggie Dude Ranch and Pet Lodge shall be entitled to reasonable attorney’s fees, costs, and necessary disbursements in addition to any fees to which said parties may be entitled.

Disclosure of medical conditions, illness, and/or behavioral Issues: *

I have read and agree with all terms of this agreement. *

Signature *

Date *

Phone

This document serves as a comprehensive information form and liability waiver for Waggin’ Tails Doggie Dude Ranch and Pet Lodge. It includes sections for pet and owner details, vet contact information, emergency contacts, as well as authorization for medical care and consent for potential risks involved in pet activities such as daycare and boarding. The form also covers property loss or damage, the use of pet’s visual images and statements, and disclosure of any medical conditions or behavioral issues. By signing and dating the form, the owner confirms their understanding and agreement to the terms outlined.

Patient Forms
Waggin’ Tails

Client Release Form

Pet's Information

Owner's Information

Vet Contact Information

Referral

Emergency Conact Info

Injury and Illness

Authorization of Medical Care

Property Loss or Damage

Photographs and Statements

Get In Touch

Have a question?

Address

Contact Information

Hours

We proudly serve the pets of Fitchburg, WI and beyond

Patient Forms Waggin’ Tails

Client Release Form

Pet's Information

Owner's Information

Vet Contact Information

Referral

Emergency Conact Info

Injury and Illness

Authorization of Medical Care

Property Loss or Damage

Photographs and Statements

Patient Forms
Waggin’ Tails