Raintree Emergency Contact Information

Resort Check in Date *

Month Day Year

Pet Information *

Pet #1 Name Pet #2 Name

Pet Information

Pet #3 Name Pet #4 Name

Client Information *

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number *

Please enter a valid phone number.

Email *

example@example.com

Alternate/Emergency Contact Information *

First Name Last Name

Alternate/Emergency Contact Phone Number *

Please enter a valid phone number.

Alternate/Emergency Contact Relationship *

(ex: Spouse, Friend, Neighbor)

In the event an injury or unforeseen health emergency arises, we make every effort to obtain approval for a treatment plan. We encourage pet owners to consult with their family members to determine an emergency care directive to be used in the event we are unable to reach a pet owner or emergency contact. *

I authorize ANY AMOUNT necessary for the treatment of my pet while in the care of Raintree Pet Resort + Medical Center. I authorize the maximum AMOUNT SPECIFIED BELOW to be used towards my pet's Emergency Care at Raintree Pet Resort + Medical Center.

Amount authorized for emergency treatment in the event Raintree Pet resort + Medical Center is unable to reach myself or the emergency contact provided:

In the event a non-emergency incident arises including minor gastrointestinal upset(vomiting, diarrhea, or lack of appetite), isolated instances of non traditional behavior, or minor abrasions from group play: *

I authorize supportive care or environmental adjustments as Raintree Pet Resort +Medical Center feels appropriate to care for my pet in my absence. I wish to be contacted for authorization prior to any non-emergency treatments I authorize the maximum amount specified below to be used towards non-emergency care at Raintree Pet Resort + Medical Center

Amount authorized for non-emergency treatment in the event Raintree Pet resort + Medical Center is unable to reach myself or the emergency contact provided:

Signature *

Clear

Date *

Month Day Year