EMERGENCY CONTACT INFORMATION

EMERGENCY CONTACT INFORMATION

Pawsitive Dog LLC * 715-222-9167 *pawsitivepetsitting715@gmail.com
Pawsitive Dog LLC requires all clients complete the Emergency Contact Information and Veterinary Release forms. In the event of an emergency, our Paw Sitter will make every attempt to contact the owner, the secondary pet parent and the emergency contact. In the event that no contact can be reached, Pawsitive's Paw Sitter will seek appropriate medical carre for your pet(s). Pawsitive's Paw Sitter will make every attemp to take your pet(s) to the Veterinarian listed below, however, if you Veterinarian is not available, Pawsitive's Paw Sitter will bring your pet(s) to an appropriate clinic.

* If your pets do not go to the same vet clinic, you will need to fill out a new form for each pet and clinic. *
Pet Name(s) *
Species: *

Cat Dog Horse
Pet Parent *

First Name Last Name
Phone # *
Spouse Pet Parent *

First Name Last Name
Phone # *
Vet Name/clinic *
Vet Phone Number: *
Vet Address: *

Street Address

Street Address Line 2

City State

Zip Code
Nearest 24 hour Emergency Clinic Name: *
This is closest for St. Croix Valley
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
If needed, how should I contact you during my visit? *
Ermergency Contact #1: *

First Name Last Name
Phone Number: *
Relationship: neighbor, friend, or relative not spouse: *
Does this person have permission to make medical or emergency decisions on your behalf in the event you can not be reached? *

Yes No
Emergency Contact #2 (optional)

First Name Last Name
Phone Number:
Relationship:
Does this person have permission to make medical or emergency decisions on your behalf in the event you can not be reached?

Yes No
Any additional info:
Veterinary Release Agreement

Pawsitive Dog LLC Paw Sitting
In the event that any of my pets appear to be ill, injured, or at significant risk of experiencing a medical problem while in the care of your Paw Sitter, I give permission to Pawsitive Dog Paw Sitter to seek veterinary service from my veterinarian or emergency veterinary clinic which are listed my pet's Emergency Contact Information.
initials* 1. In the event of an emergency, I understand that the Pawsitive Dog LLC Paw Sitter will make every attempt to contact the Pet Parents and the emergency contact.
initials* 2. If no contact can be reached, I authorize Pawsitive Dog LLC Paw Sitter to appropriate medical treatment for my pet(s).
initials* 3. I understand that every effort will be made to take my pet(s) to the above Veterinarian, however, I authorize Pet Sitting Company to seek treatment for my pet(s) any appropriate clinic, if necessary.
initials* 4. I understand that Pawsitive Paw Sitters work hard to prevent accidents and injuries, and that such problems may occur no matter how well a pet is cared for. I agree to allow Pawsitive Paw Sitter to use their best judgment in handling these situations, and I also understand that Pawsitive Dog LLC and its Paw Sitters assume no responsibility for the actions and decision of the veterinary staff, the health, or death of my pet(s).
initials* 5. I authorize Pawsitive Dog LLC and the Veterinarian caring for my pet(s) to share all medical records of my pet(s) with the emergency vet clinic in an effort to provide the best care possible.
initials* 6. I give permission to Pawsitive Dog LLC to approve treatment up to: $___________.
initials* 7. I agree to assume full responsibility for payment and reimbursement for any and all veterinary services rendered.
initials* 8. I understand that Pawsitive Dog LLC assumes no responsibility for the loss or injury of any pet(s) and is released from all liability related to transportation, treatment and expenses.
initials* 9. This agreement is valid from the date below and grants permission for all future veterinary care without additional
authorization each time Pawsitive Dog LLC cares for my pet(s).
I understand that by signing this agreement that I have the sole authority to make health, medical and financial decisions regarding the pets that will be scheduled to recive service from Pawsitive Dog LLC.
Date *

Month Day Year
Date
Signature *

Clear
Should be Empty:

EMERGENCY CONTACT INFORMATION

Veterinary Release Agreement