Dog Info Form

Dog Info Form

we can no longer take male dogs over the age of one that are not neutered.

All dogs must be up to date on Rabies, Distemper, Bordetella (kennel cough) vaccinations.  Please provide a copy of vaccinations.

I understand that my dog’s stay at Gussie’s Place is not without the possible risk of illness or injury, even when the utmost care is taken. I agree not to hold Gussie’s Place – Gail and Jerry Stewart or any employee, responsible or liable for such injury or illness should that injury or illness occur even when all normal and reasonable precautions have been taken. At Gussie’s Place we always try to contact the owner in the event of an accident or injury, but in the event of a true emergency, we put the dog’s needs first and foremost. In the event that my dog needs medical assistance (including anesthesia), I agree not to hold Gussie’s Place – Gail and Jerry Stewart or any employee, animal hospital or any other veterinary or emergency clinic, responsible or liable for unexpected reactions to medications or anesthesia when all normal and reasonable precautions have been taken. I have read the above disclaimer and agree to it's terms.* In case of an emergency and my dog needs to be seen by a veterinarian I give Gussie's Place, Gail Stewart, and Chris Smolnik permission to to do so.  Rockingham Veterinarian in Chester, Vermont is our emergency Veterianarian.  We will do our best to contact your veterianarian on record first.  All charges will be paid for by the owner of the dog.