EmailMe Form - Vet Release

Owner's Name

First Last

Owner's Primary Email

Dog's Name(s) Multiple dogs OK

Vet's Name

Clinic Name

Clinic Address

Vet's Phone

Alt Phone if available (i.e. your vet's cell/home phone)

PERMISSION TO TRANSPORT: I am the above dog's owner and I hereby give Rawhide Ranch Dog Boarding permission to transport my pet(s) to the above veterinarian and authorize treatment in the event of an emergency or sickness.

I agree with this statement

I do not agree with this statement

VET OPTIONS: If this veterinarian is not available, I authorize Rawhide Ranch Dog Boarding to transport my pet(s) to a veterinarian of choice and authorize treatment. If emergency care is needed after regular office hours, my pet(s) may be taken to the nearest Veterinarian Emergency Clinic/Hospital.

I agree with this statement

I do not agree with this statement

AUTHORIZATION TO TREAT AND PAY: In the event of an emergency, I authorize you (veterinarian) to administer medical treatment and will be responsible for payment to you (veterinarian) upon my return.

I agree with this statement

I do not agree with this statement

TREATMENT LIMITS: I give permission to Rawhide Ranch Dog Boarding to approve treatment up to the amount below. I agree to be responsible for all charges upon my return.

Up to $500

Up to $750

No Limit

RELEASE FROM LIABILITY: I agree that Rawhide Ranch Dog Boarding is released from all liability related to transportation to and from veterinarian and treatment for sickness or emergency.

I agree with this statement

I do not agree with this statement

This release will remain valid for all current and future visits unless a new release is signed.

I agree with this statement

I do not agree with this statement

Owner's Electronic and binding signature.