Lexington Dog Walk - Veterinary Release Form
Owner's Full Names
Owner's Email
Dog's Full Name
Dog's DOB
Physical Address
Telephone Number 1
Telephone Number 2
TO WHOM IT MAY CONCERN
I hereby authorize the (Veterinarian's Office Name and Number)
to treat any of my pets as listed on the Pet Information sheet and I accept full responsibility for all fees and charges incurred in the treatment of any of my pets limited to the following amount:
Veterinary Treatment Limited to $
Lexington Dog Walk 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, the Sitter shall act on my behalf to authorize any treatment excluding euthanasia.
Pet Sitter's Full Names
Dog's Name
Date
Electronic Signature
I have read the above terms and conditions. I know, understand, and agree to all terms stated above. By typing my name below and submitting this form electronically, I acknowledge and agree that my typed name constitutes a legally binding signature and
I am accepting this document as a contractual agreement.
Owner's Name
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