SOUTH MAUI ANIMAL CLINIC
CENTRAL MAUI ANIMAL CLINIC
WEST MAUI ANIMAL CLINIC
DIRECT RELEASE TESTIMONIALS
DIRECT RELEASE FORMS
OUR ANGEL FUND
Direct Release Checklists
South Maui Animal Clinic - Central Maui Animal Clinic - West Maui Animal Clinic
Indicates required field
Emergency Contact Name
Emergency Contact Phone
For Multiple Dogs
Separate Kennel Runs
Shared Kennel Run
Pet Feeding Option
Owner Provided Diet
Once a Day
Twice a Day
For Once a Day Feedings, Please Type "AM" or "PM" in the Box Below.
Dry Food Amount (cups?)
Wet Food Amount (cups?)
Drop-Off Time (Hours are 8am-4pm)
Pick-Up Time (Hours are 8am- 4pm)
Name of Regular Flea and Tick Product
Date Flea/Tick Product Was Last Given
*Flea/Tick Product is Required.
I understand that all pets should be treated with an approved flea/tick preventative prior to entering boarding. I understand that if my pet has not been treated, (and/or) parasites are found, the staff will administer treatment and my account will be charged accordingly.
I understand that all payment must be received upon drop-off or prior to your pets' boarding reservation.
I understand that should my pet need a medical examination, treatments, toe nail trim, or a bath while boarding I am responsible for payment of these items at time of pick up.
If someone other than the owner(s) will be picking up your pet:
I give the following person(s) authorization to pickup my pet(s) on the check-out date listed above (Driver’s License will be required to release pet):
Client's Electronic Signature
If You Would Like to Request a Toe-Nail-Trim, ($15.00), Please Type "YES" in the Box Below.
Please List Any Known Allergies Your Pet(s) Have
List of Pet(s) Belongings/ Other Comments
Central Maui Animal Clinic
South Maui Animal Clinic
West Maui Animal Clinic
Call or Text
(808) 893-2380 Call or Text (808) 446-4010
Call or Text