Emergency Veterinary Release | Paws For Adventure

Emergency Veterinary Release Form

Paws for Adventure LLC requires all Clients to complete a Veterinary Release Form. This agreement is effective from today’s date and is between Paws for Adventure LLC, the pet walker/sitter (hereinafter referred to as “Owner”), and you (hereinafter referred to as “Client”). By using this electronic document, you agree to use an electronic signature which acts as a manual signature. If you prefer to fill out the Emergency Veterinary Release Form on paper, please contact Paws for Adventure LLC and a paper copy of the required documents will be provided.

Client Information

Client First name

Client Last name

Phone Number

Client #2 Name

Phone Number

Veterinary Information

Veterinary Office

If you do not have a Veterinary Office please indicate where you prefer your pet to be taken in case of an emergency

Preferred Veterinarian

Phone Number

Secondary Phone Number

Address

I agree to the following:

In the case of an emergency, Client understands that Owner will make every attempt to contact the primary Client, secondary Client and emergency contact(s).
If no contact can be reached, Client authorizes Paws for Adventure LLC to approve appropriate medical treatment for Clients pet(s) as recommended by a veterinarian (excluding euthanasia).
Client understands that Paws for Adventure LLC and Owner work hard to prevent accidents and injuries and that such problems may occur no matter how well a pet is cared for. Client agrees to allow Paws for Adventure LLC and Owner to use best judgment in handling these situations, and Client understands that Paws for Adventure LLC and Owner assume no responsibility for the actions and decisions of the veterinary staff, the health, or death of my pet(s).
Client understands that Paws for Adventure LLC assumes no responsibility for the loss or injury of any pet(s) and is released from all liability related to transportation, treatment, and expenses.
Client understands that every effort will be made to take my pet(s) to the above Veterinarian, however, Client authorizes Paws for Adventure LLC to seek treatment for pet(s) at any appropriate clinic, if necessary.

Client hereby relieves the Veterinarian and Paws for Adventure LLC of any responsibility for injury and/or death of my pet which may have been prevented by care beyond the financial limit I have authorized.
Client authorizes Paws for Adventure LLC and the Veterinarian caring for Clients pet(s) to share all medical records of pet(s) with emergency vet clinics in an effort to provide the best care possible.
Client agrees to assume full responsibility for payment and reimbursement for any and all veterinary services rendered. Client agrees to reimburse Paws for Adventure LLC for any expenses incurred attending to this need within 14 days of each incident.
This agreement is valid from the date below and grants permission for all future veterinary care without additional authorization each time Paws for Adventure LLC cares for Clients' current and future pet(s) within Paws for Adventure LLCs care until the Service Agreement is terminated.

I have read the above terms and conditions. I know, understand, and agree to all terms stated above. By signing below, I am accepting this document as a contractual agreement. Once completed and reviewed by Paws for Adventure LLC, a copy of the signed document will be sent to me using the email address I provided.

First and Last Name

Today's Date

Signature

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