Riverwalk Pet Hospital - payment options

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Grooming Waiver

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Please fill out this form as entirely and accurately as possible so we can get to know you and your pet(s) before your visit.

Name *

First

Last

Phone *

Liability Release Waiver:
I understand that I am solely responsible for any harm caused by my dog(s) while my dog(s) is/are receiving grooming services at Riverwalk Pet Hospital & Resort. (RPHR). I also understand and agree that in admitting my dog(s), RHPR has relied upon my representation that my dog(s) is/are in good health and have not harmed or shown aggressive or threatening behavior towards any person or any other dog. If I am unreachable in the event of an emergency, I hereby authorize RHPR, its agents, and/or representatives to perform immediate veterinary care for my dog based on the options I chose. I understand that all costs in connection with veterinary, medical or other treatment, shall be my responsibility. I hereby release and agree to save and hold harmless, RHPR, its directors, officers, employees, assistants, members and agents from any and all liability, claims, suits, actions, loss, injury, or damage of any nature or kind, or for any liability, claims, suits, actions, loss, injury or damage which I or my dog(s) may sustain or which may be caused in any way by my dog(s). I specifically, without limitation, agree to fully indemnify RHPR for any and all such liability, claims, suits, actions, losses, injury or damage. Although we carefully screen all applicants, occasionally we discover that this is not an appropriate environment for every dog. RHPR reserves the right to deny admittance to Owner’s pet for any reason at any time.

Coat Condition:
I understand that RPHR puts my pet's comfort and safety above all else. In the event that my pet’s coat is matted, I understand that the groomer may have to shave the matts out rather than perform a painful dematting procedure. I also understand that if my pet is severely matted, a licensed veterinarian will need to examine my pet and a treatment plan will be created based on the additional services needed.

Intestinal/External Parasites:
If a pet within the care of RPHR is found to have intestinal parasites, their stool will be tested and if it yields a positive result, an examination will be performed (if not current) and a dewormer will be prescribed by one of our veterinarians at the owner's expense. If a pet is found to have fleas and/or ticks, a veterinarian will prescribe medication to treat the current infestation and will prescribe a flea/tick prevention at the owner's expense. We recommend all pets to be current on flea, tick, and heartworm prevention year around. If a pet’s fecal test shows a positive result, the pet will not be able to return until treatment is complete and yields a negative fecal test result.

RPHR requires the following vaccinations/tests:
Dogs: Rabies (initial vaccine booster after 1 year, then administered every 3 years thereafter), DHPP (every 3 years) Bordetella (every 6 months), Bivalent Canine Influenza (H3N8 and H3N2) (yearly), Fecal (yearly) * pet has tested negative within the last 12 months.
Cats: Rabies (initial vaccine booster after 1 year then, administered every 3 years thereafter), FVRCP (yearly), Fecal (yearly) * pet has tested negative within the last 12 months.
A written proof of vaccinations from a licensed veterinarian is required. Verbal notice is not an acceptable form of proof. If a pet is not current on the required vaccinations and tests for grooming, the pet will need to have an exam with an RPHR veterinarian and those required vaccinations and tests will be performed at the cost of the owner. These accommodations must be made at time of scheduling grooming. Allow extra time at check in as a technician will need to also speak with you.

I certify that I have read and understand the rules and regulations set forth herein and that I read and understand this agreement. I agree to abide by the rules and regulations and accept all the terms, conditions and statements of this agreement and confirm the truthfulness of the contents of the Application form completed by me.

I understand in order to protect the health of your pet(s) and the hospital’s patients, all pets boarding, grooming, or in daycare at RPHR must have had a full exam done within the last year and be current on all required vaccines. If these services are not current, they will be performed upon admitting your pet(s) for boarding at the owner's expense. *ALL VACCINATIONS MUST BE ADMINISTERED BY A LICENSED VETERINARIAN.*

I understand that in the event my pet(s) becomes ill or requires medical attention while boarding with RPHR, the staff will attempt to contact me. If the staff cannot reach me or my emergency contact, I understand that they will proceed with life saving measures, at my personal expense until I can be reached. I give RPHR permission to sedate, perform supportive care and/or provide life saving treatment deemed necessary for the health and safety of my pet(s). In the event RPHR medical staff are unable to contact either myself or my designated emergency contact, I authorize RPHR: *

Any amount necessary for the treatment of my pet(s).
I want to set a maximum for the treatment of my pet(s). See below.

I understand if my pet's coat is matted, the groomer may have to shave the mats out rather then perform a painful dematting procedure. If my pet is severely matted, there is an increased risk for clipper burns or cuts to the skin. All attempts will be made to prevent this, however in many severe mat conditions, this is unavoidable. I also understand that matted pets take additional time and there will be additional charges added to a regular groom price if my pet's coat is matted.

I understand and agree that any incurred boarding, daycare, grooming or medical expenses will be the responsibility of the owner or agent and must be paid for at the time the pet is picked up. *RPHR DOES NOT ACCEPT CHECKS OR DO PAYMENT PLANS.*

Besides myself, I release the following person to pick up my pet(s):

Name *

First

Last

Phone

Relation

Emergency Contact -
**I authorize my emergency contact to make medical and financial decisions in my absence.**

Name *

First

Last

Phone

Relation

Signature *

Clear Signature

Date *

Online Forms

Grooming Waiver

Grooming Waiver

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