Consent and Waiver Form

Waiver and Release Form

Please complete this form before your scheduled in-home visit. This helps us provide safe, comfortable, and personalized care for your pet(s) in the comfort of your home.
Name*

First NameLast Name
Phone Number*
Pet's Name*
Pet's Date of Birth*

MonthDayYear
Date. If unsure, please guess approximate Date.
Approximate Weight*
In Lbs.
Species*
Breed*
How long have you had your pet?*
Medical History and Information
Date of Rabies vaccination *

MonthDayYear
Kindly ensure you have valid proof of vaccination available.
When is your pet's next Rabies vaccination due?*

MonthDayYear
Is your pet spayed or neutered?*

YesNo
Does your pet have any known allergies or skin conditions?*
If None, type None
Are there any places your pet does not like to be touched?*
If None, type None
Is your pet afraid of any of the following? (Check all that apply)*

ThunderstormsFireworksMost Loud NoisesWind/RainNoneOther
Which best describes your pet's energy level?*

LowMediumHIgh
Which 3 adjectives best describes your pet's personality?*

CalmEasy-GoingWorriedInquisitivePatientAffectionateNeedyProtectiveGoofyPlayfulBossyIntenseVocal
Is your pet on flea, tick, and heartworm prevention?*

YesNoIf yes, which brand
Has your pet ever bitten anyone?*

NoYesIf yes, please explain
Please provide other comments or information about your dog that you feel might be helpful:
Consent and Waiver
I authorize T&B Pets and its licensed veterinary technician, Lakell Silva, to perform pet care services for my pet(s) at the address listed above. I understand that these services may include, but are not limited to, basic medical care, administration of medication, nail trimming, and other non-emergency services as discussed and agreed upon in advance.I confirm that I have disclosed all relevant medical history, behavioral concerns, allergies, and known conditions pertaining to my pet(s). I understand that failure to provide accurate or complete information may increase the risk of complications or injury, and I release T&B Pets and its representatives from any liability resulting from such omissions.In the event of a medical emergency during a scheduled visit, I authorize T&B Pets to take reasonable actions necessary to ensure the safety and well-being of my pet(s), including transportation to the nearest emergency veterinary facility. I understand and accept full financial responsibility for any veterinary treatment or services rendered as a result.I understand that T&B Pets will take every reasonable precaution to ensure the safety and comfort of my pet(s) during in-home visits. However, I acknowledge that no service is without risk. Accordingly, I agree to release and hold harmless T&B Pets and its representatives from any liability for injury, escape, illness, or death of my pet(s), except in cases of gross negligence or willful misconduct.I agree to indemnify and hold harmless T&B Pets, its employees, contractors, and representatives from any claims, actions, damages, or expenses (including attorney's fees) arising out of or related to services provided, except in cases of gross negligence or willful misconduct."I authorize T&B Pets to enter my home for the purpose of providing scheduled care for my pet(s). I confirm that my home environment is safe for both my pet(s) and the visiting technician. I understand that I am responsible for securing any potentially hazardous areas, items, or other animals prior to the visit to prevent injury or incident.I give permission for T&B Pets to photograph my pet(s) and use such images for business purposes, including but not limited to social media, marketing materials, and promotional content. I understand that no identifying personal information will be shared without my additional consent.I understand that T&B Pets and its representatives are not veterinarians and do not diagnose or treat medical conditions. I acknowledge and accept all risks associated with the services provided, and agree that T&B Pets is not liable for undetected or underlying medical issues.I understand that ongoing services may require periodic updates to this form and that I am responsible for informing T&B Pets of any changes to my pet's condition, environment, or behavior before each scheduled visit.This agreement shall be governed by the laws of the State of Texas. Any disputes arising under this agreement shall be resolved through mediation or arbitration before pursuing legal action.I understand that T&B Pets does not operate as a 24-hour emergency service and may not be available outside of scheduled visits. In the event of an emergency outside scheduled hours, I am responsible for contacting a licensed veterinary provider.I understand that payment for service(s) is required at the time of service completion.I acknowledge that cancellations must be made at least 24 hours in advance or a cancellation fee may apply.I acknowledge that all information I have provided in this form is true, complete, and accurate to the best of my knowledge.
Signature*

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Date*

MonthDayYear
Date
Thank you for helping us understand your pet better. Please let us know if we can answer any questions! Feel free to contact us anytime via phone (682) 888-7087 or via email at contact@tandbpets.com. You can also visit our website at https://tandbpets.com/
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Waiver and Release Form