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Vet:
Pets Name/Names:
During my various
absences, Teak Time Pet Sitting Service Inc) will be caring for
my animal(s). They have my permission to transport them to and
from your office or, in the case of large animals, request "on
site" treatment from your office as is deemed necessary.
I authorize you to treat my animal(s) and I will be fully responsible
for all fees and charges and will pay for all charges they incur
on my behalf upon my return. I further authorize you to give
out any information about my animal(s) to , the owner of Teak Time
Pet Sitting Service Inc
Client Initials
Teak Time Pet
Sitting Service Inc Urgent Veterinary Treatment Authorization
This form will
be retained on file and will be used to authorize urgent veterinary
treatment in the event that your pet(s) require such treatment
during your absence and we are unable to contact you at the time.
Should you change Vets please notify Teak Time
Pet Sitting Service In before service dates.
Client Name:
Email:
Address:
City: ZIP:
Home Telephone:
Work Telephone:
Mobile/Pager:
To whom it
may concern: I have contracted for services from Teak Time Pet
Sitting Service Inc. during my absence and I authorize Teak Time
Pet Sitting Service into act on my behalf to request veterinary
treatment and services when they deem it necessary. I accept
full responsibility for charges incurred in the treatment of
my pet(s), not to exceed the following amounts for each pet:
Pet Name- Description-
Maximum Amount
$
$
$
$
$
If multiple
pets require treatment, do not exceed a combined total of
$.
Special Instructions:
Teak Time Pet
Sitting Service Inc. reserves the right to utilize the services
of any available veterinary clinic. If time permits, we will
attempt to utilize your primary veterinary clinic. If it is not
practical to do so, the following information will be helpful
if the clinic we utilize requires documentation from your primary
clinic.
Preferred Urgent
Veterinary Care
Clinic Address Telephone
I authorize
you to treat my animal(s) and I will be fully responsible for
all fees and charges and will pay for all charges that are incurred
on my behalf, immediately upon my return. CC Card If I cannot
be reached:
Name
CC #
Exp.
Max. Charge Authorized . Authorized charges to this card are for Veterinarian
Services/Pet Medications ONLY.
Client Signature
Date
_____________________________
Teak Time Pet Sitting Service Inc |