Veterinary Release

In the event of a medical emergency where Calico Pet Sitting, Ltd cannot contact you to authorize care immediately and directly, Calico Pet Sitting, Ltd. will use this form to obtain care. I, the undersigned Pet Owner, agree that in the event that any of my pet(s) appears to be ill, injured or at significant risk of experiencing a medical problem at the start of service or while in the care of Calico Pet Sitting, Ltd., to seek veterinary care. Any reference to Calico Pet Sitting, Ltd. shall include the officers, employees and authorized agents or contractors of Calico Pet Sitting, Ltd. I authorize Calico Pet Sitting, Ltd. to seek veterinary service from any veterinarian or a veterinary care provider if Calico Pet Sitting, Ltd. deems it necessary for any of my pets in the care of Calico Pet Sitting, Ltd. My preferred veterinary care provider is: *

Name of preferred Veterinarian or Veterinary Clinic:

Address of Veterinarian *

Veterinarian Phone Number *

I hereby give Calico Pet Sitting, Ltd. my express permission to transport any of my pets for care to the above mentioned veterinarian (or to closest open facility if the primary veterinary office is not available). Other veterinarians or emergency care providers chosen by Calico Pet Sitting, Ltd. are acceptable. I hereby request that Calico Pet Sitting, Ltd. inform the veterinarian or veterinary service provider that I request a total diagnosis and treatment limit of *

Submit the dollar amount per animal you are authorizing the veterinarian to spend.

I understand that efforts will be made to contact me regarding any treatments, illness, injury, or potential problems as soon as the condition is deemed not life threatening and/or contact is possible. I authorize Calico Pet Sitting, Ltd. and my primary veterinarian(s) to release the medical records of any or all of my pet(s) to any veterinary care providers in an emergency as necessary to provide the best care for any ill or injured animal. *

Please initial in the box above. By initialing, you are acknowledging that you have read and agree with the above information.

I agree to hold Calico Pet Sitting, Ltd. harmless from any liability arising from the treatment and care provided by veterinarian, veterinary care providers and the employees and agents of same. I agree that Calico Pet Sitting, Ltd. shall not assume any responsibility for the payment for any of veterinary services rendered, which may include but are not limited to diagnosis, treatment, grooming, medical supplies, and boarding. I also agree that I shall assume full responsibility for any such services and that I will reimburse Calico Pet Sitting, Ltd. for any payments for services made on my behalf. I further agree to assume full responsibility for all special service fees assessed by Calico Pet Sitting, Ltd. for emergency transportation, care, supervision, or hiring of emergency caregivers, and I will pay such fees within 10 days of any such incident. *

Please initial in the box above. By initialing, you are acknowledging that you have read and agree with the above information.

This release agreement shall remain in full force and effect from the date below and for all visits with Calico Pet Sitting, Ltd. I agree that no additional authorization shall be required of Calico Pet Sitting, Ltd. to secure the services set herein while my dog is in the care of Calico Pet Sitting, Ltd. By signing this contract, I am representing to Calico Pet Sitting, Ltd. that I have the sole authority to make health, medical, and financial decisions regarding the animals I have delivered to Calico Pet Sitting, Ltd.’s care. I hereby declare to Calico Pet Sitting, Ltd. that I am the legal owner of my animal; that my animal has not been exposed to distemper, rabies, or parvovirus within the past thirty (30) days that my animal has been inoculated as indicated by records which have been presented to Calico Pet Sitting, Ltd. By signing below, I acknowledge that I have read this agreement in its entirety and agree to the terms. *

Please initial in the box above. By initialing, you are acknowledging that you have read and agree with the above information.

By typing my name below, I am electrically signing the Veterinary Release from Calico Pet Sitting, Ltd. *

Please type your full name in the box above. By typing your name, you acknowledge that you have read and agree with the Veterinary Release Agreement from Calico Pet Sitting, Ltd.

Date *

Name