Veterinary Release

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VETERIARIAN

Hospital and Vet’s Name: __________________________________________________

Address: ________________________________________________________________

Phone: _________________________________________________________________

To the Hospital:

Riley & Phoebe’s Cottage LLC has been contracted to provide pet sitting services for my pet(s) and is authorized to place them in your care in the event of an emergency. Riley & Phoebe’s Cottage LLC will make every effort to contact me promptly should medical treatment become necessary. However, if I cannot be reached immediately, I hereby authorize you to administer any necessary medical care to my pet(s) and agree to be responsible for all associated expenses as outlined below. Please retain this form in my pet’s records.

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Pet Owner: _____________________________________________________________________________

Address: _______________________________________________________________________________

Phone: _________________________________________________________________________________

Pet(s): __________________________________________________________________________________

If the above-named veterinarian is unavailable, I authorize another veterinarian within the same practice to provide care for my pet(s). In the event that neither veterinarian is available, I grant permission for Riley & Phoebe’s Cottage LLC to transport my pet(s) to the nearest animal hospital or emergency clinic for necessary treatment.

1. I give permission for Riley & Phoebe’s Cottage LLC to approve treatment up to $______. (____ initial)

2. I acknowledge that Riley & Phoebe’s Cottage LLC assumes no responsibility for the loss of any pet and is released from all liability associated with transportation, medical treatment, and related expenses.

3. Other conditions, if any: _______________________________________________________________

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My pet(s) has/have the following health issues: ___________________________________________________

_____________________________________________________________________________________________

This consent for treatment has no expiration date unless otherwise noted.

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        _________________________________________________________

        Client                                                                              Date

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        _____________________________________________________________________________________________________________

        Client                                                                              Date             Riley & Phoebe’s Cottage LLC                       Date