Worsley Cat Sitter

Client Information and Veterinary Release Form

Name

Address

Phone Number

Email

Emergency Contact Name

Emergency Contact Number

Registered Vet

Do you have pet insurance?

If yes, please input details of insurance below

Number of Cats

Cat Name(s)

Age(s)

Genders(s)

Colour(s)

Microchip

Medical Information

Feeding Schedule

Additional Information

Veterinary Release

During my absence, Worsley Cat sitter will be caring for my cat(s). In the event of an emergency, I authorise you (veterinarian) to administer medical treatment and I will be responsible for payment to you (veterinarian) upon my return. I give Worsley Cat Sitter permission to transport my cat(s) to a local veterinarian and authorise treatment in the event of an emergency or sickness. I agree to authorise the veterinarian to euthanise my cat in EXTREME circumstances after all reasonable attempts have been made to reach me or my emergency contact.

In the event of my cat's death, I would like the cat to be kept at the vet until my return.

I agree that Worsley Cat Sitter is released from all liability related to transportation to and from the veterinarian and treatment for sickness or emergency.

This release form will remain valid for all current and future visits unless a new release form is signed.

I give permission for Worsley Cat Sitter to approve treatment up to the amount stated below. I agree to be responsible for all charges upon my return including, but not limited to, vet fees, extra visit fees and transportation fees.

Fill out the box below with a value.

Value

I agree to Worsley Cat Sitter Terms & Conditions

Please Sign Below

Worsley Cat Sitter

2 Duchy Avenue, Worsley, M28 7HB