Veterinary Release Form

Pet's Name

Pet's Breed/Description

Pet's Name

Pet's Breed/Description

Pet's Name

Pet's Breed/Description

Vet Office

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number

Area Code Phone Number

I authorize the following expenditure: $

I hereby authorize the attending Veterinarian to treat any of my pets listed above.

Happy At Home Professional Pet Care 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, Happy At Home Professional Pet Care shall act on my behalf to authorize any treatment excluding euthanasia.

I/We will assume full responsibility upon my return for payment and/or reimbursement for Veterinary services rendered up to the above stated amount.

If neither of the Veterinary clinics named above is available, I authorize Happy At Home Professional Pet Care to take my pet(s) to another Veterinary clinic for treatment. I understand that Happy At Home Professional Pet Care cannot be held responsible for the results of the Veterinary treatment or the loss of my pet.

This agreement is valid starting on the date below and whenever Happy At Home Professional Pet Care cares for my pet(s).

Owner's Signature:

Date