Shadow & Marty’s Pet Care Services

Contact:  Dedi Wood

Office:  214-501-4690

Email:  yourpetcareservices@yahoo.com

                                    Vet Release Form

Pet Information       Veterinarian Information

Type of Animals: _____________________________   Veterinarian: ___________________________

Animal’s Names: _____________________________   Address: ______________________________

Birth Dates: _________________________________   Phone: ________________________________

Known medical conditions: ____________________________________________________________

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During my absence, Shadow & Marty’s Pet Care Services will be caring for my pet(s).  In the event of an emergency, I authorize you (veterinarian) to administer medical treatment and will be responsible for payment to you (veterinarian) upon my return.

I, _________________________________, give Shadow & Marty’s Pet Care Services permission to transport my pet(s) to the above veterinarian and authorize treatment in the event of an emergency or sickness.

 

If this veterinarian is not available, I authorize Shadow & Marty’s Pet Care Services to transport my pet(s) to a veterinarian of choice and authorize treatment.  If emergency care is needed after regular office hours, my pet(s) may be taken to the nearest Veterinarian Emergency Clinic/Hospital.

I give permission to Shadow & Marty’s Pet Care Services to approve treatment up to $______________________ (input maximum dollar amount or “no limit”).  I agree to be responsible for all charges upon my return including, but not limited to, vet fees, extra visit fees and transportation fees.

I agree to authorize veterinarian to euthanize my pet in extreme circumstances after all reasonable attempts have been made to reach me or my emergency contact.

In the event of my pet’s death, I would like the pet cremated / kept at vet / other: __________________.

I agree that Shadow & Marty’s Pet Care Services is released from all liability related to transportation to and from veterinarian and treatment for sickness or emergency.

This release will remain valid for all current and future visits unless a new release is signed.

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        Client’s Signature       Date