Care of Pets

Care of Pets
This form will help ensure the veterinary care of your pet while you are away from them and they are being cared for by a pet sitter. Please fill out all information to assist a veterinary clinic to care for your pet if the event of an emergency.

Pet Owner Information
Name*

First NameLast Name
Spouse Name

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternative Number
Please enter a valid phone number.Format: (000) 000-0000.
Spouse Number
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Pet Insurance Company Name & Policy # (if applicable)
Credit Card Information

Either fill out your credit card information or provide and image.
Name on Card

First NameLast Name
Credit Card Number
Expiry Date
CVV
3 Numbers on Back of the Card
Rather than filling out the above information you can upload an image of the front and back of your Credit card.

Front of Credit Card:
Back of Credit Card:

Pet Sitter Information
Pet Sitter Name*

First NameLast Name
Pet Sitter Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pet Sitter Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Emergency Contact Information

If different than any of the above information
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name

Consent
To whom it may concern,
This letter is to allow the aforementioned party to have full rights to consent to treatment of the following animal(s) pet's name*, pet's name* during the time period from Date* to Date*. We can be contacted at Area Code* Phone Number*, please feel free to contact me to get instructions for care. If extensive care is warranted or even euthanasia is indicated, all efforts should be made to contact us or our alternative emergency contact provided above. In case of an emergency my credit card can be billed up to $indicate dollar amount*.

Please take my signature as consent to all information provided on this form.
Owner's Signature*
Date Signed*

MonthDayYear
Date
By submitting this form, I agree to the Privacy Policy and consent to the processing of my personal data as described therein.

*Once the form is submitted, a copy will be sent to your email automatically.
Should be Empty:

Pet Owner Information