Veterinary Release

Title: Veterinary Information

Veterinary Information

Hospital/Clinic Name

Veterinarian's Name

Address

Phone

Spacer

24 Hour Emergency Veterinary Hospital

Address

Phone

Title:To the Hospital

To the Hospital

Furmiliar Comfort has been contracted to pet sit for my pet(s) and has my permission to place them in your care in case of an emergency. Furmiliar Comfort will attempt to contact me as soon as medical care is deemed necessary. However, in the event I cannot be reached immediately, I authorize you to treat my pet(s), and I will be responsible for payment of any fees as stated below.

Please file this form with my records.

Client/Pet Owner

Address

Phone

Pet(s)

My pet(s) have the following health issues

Client Agreements

If the veterinarian named above is unavailable, I authorize another veterinarian from their practice to care for my pet(s). If no one from the practice is available, I grant Furmiliar Comfort permission to take my pet(s) to the nearest animal clinic or emergency hospital.

I understand that Furmiliar Comfort assumes no responsibility for the loss of any pet and is released from all liability related to transportation, treatment, and expense.

If I cannot be reached by phone, I give Furmiliar Comfort permission to approve treatment for my pet(s) up to

Other conditions, if any

No Expiration

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

Client Signature