Consent Form
Veterinarian-Emergency- Veterinarian- Event of Emergency
Client Name
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First Name
Last Name
Preferred Veterinarian: ( include name, phone & address.
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Emergency Contact: PLEASE list as many names & numbers as possible. In the event there is bad weather such as snow, flooding etc, and Ashley's Ark is unable to come to your home. This is also if in the case Ashley's Ark Is unable to come due to unforeseen issues such as Car accident Medical emergency etc. It is best to have someone on file who can in an emergency situation come and provide care to your pet(s).
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I hereby authorize the attending veterinarian to treat any of my pets as listed on the Pet Information sheet and I accept full responsibility for all fees and charges incurred in the treatment of any of my pets. Ashley's Ark Pet Sitting LLC is authorized to transport my pet(s) to and from the veterinary clinic for treatment or to request "on-site" treatment if deemed necessary. If I cannot be reached in case of an emergency, the Sitter shall act on my behalf to authorize any treatment excluding euthanasia.
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I understand & agree to the above terms.
Submission & signature of this form gives Ashley's Ark Pet Sitting LLC permission to care for my pet (s) in my home as well as Key & Gate access; permissions to administer medications listed in pet (s) profile to my pet (s); in an emergency situation I give permission for Ashley's Ark Pet Sitting to take my pet (s) to the listed veterinarian or closest Emergency Veterinarian Clinic . In the event veterinarian care is needed for my pet (s) I agree and understand that I the client am financially responsible for all veterinarian costs; unless it is the fault of Ashley's Ark Pet Sitting LLC Per payment of invoice I understand and agree to the terms & services that are being provided for my pet(s) in my home.
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I understand & agree to the above terms
Date
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Month
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Day
Year
Date
Signature : MUST BE CLEAR SIGNATURE
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Submit
Should be Empty: