Bone Voyage, Inc.
Individualized loving care
...when you can't be there
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Bone Voyage, Inc. Individualized loving care ...when you can't be there |
Bone Voyage Contract
Retain a printed version for our walker/sitter to pick up during our Introduction Visit!
Owner Name(s):__________________________________________________
Address:________________________________________________________
City:____________________________ State:________ Zip:______________
Home Phone:____________________ Business Phone:__________________
Email Address:________________________ Cell Phone:_________________
Veterinary Information:_____________________________________________
How did you hear about Bone Voyage, Inc.?____________________________
Dog Name Cat Name
1. Name:_____________________ 1. Name:______________________
Breed:_____________________ Breed:______________________
Color/Markings______________ Color/Markings_______________
Age/DOB__________________ Age/DOB___________________
Male/Female (circle one) Male/Female (circle one)
2. Name:_____________________ 2. Name:______________________
Breed:_____________________ Breed:______________________
Color/Markings______________ Color/Markings_______________
Age/DOB___________________ Age/DOB___________________
Male/Female (circle one) Male/Female (circle one)
3. Name:_____________________ 3. Name:______________________
Breed:_____________________ Breed:______________________
Color/Markings______________ Color/Markings_______________
Age/DOB___________________ Age/DOB___________________
Male/Female (circle one) Male/Female (circle one)
Medical information/history:__________________________________________
Medicines presently taking(w/dosages):________________________________________________
Special Instructions (including special dietary needs):______________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
I give Bone Voyage, Inc. and its employees (representatives) permission to take my pet(s) to the veterinary hospital as noted or to Belle Haven Animal Medical Center if they deem necessary. I accept full responsibility for all bills incurred under such circumstances, including any extra services performed by Bone Voyage, Inc. or its employees as a result of those circumstances.
Please inform Bone Voyage, Inc. of your pet's medical history or any medical problems. Please leave clear written instructions for feeding and/or medicating.
I understand that prompt payment is due when services are rendered. Please make all checks payable to Bone Voyage, Inc. There is a $25.00 charge on all returned checks and a 1.75% per month (21% per annum) on any unpaid balances in excess of thirty (30) days.
I understand that my keys may be kept on file with Bone Voyage. If I elect not to have them kept on file, I understand that there will be a charge equal to the cost of a regular visit for pickup/return of your key.
I have read the above, understand, and agree with the contents of this contract.
Authorization: _______________________________ Date: ________________
Bone Voyage, Inc. is proud to be a member
of: 
