Veterinary Release Form | Jaxy Cats Pet Services

Jaxy Cats Pet Services – Veterinary Release Form

This form authorizes Jaxy Cats Pet Services to obtain emergency veterinary care for your pet(s) in your absence and ensures we can act quickly in case of illness or injury.

Pet Owner Information

First name

Last name

Phone

Service Address:

Address

Emergency Contact (other than owner)

Name and Phone Number of emergency contact

Primary Veterinarian Information

Clinic Name

Veterinarian Name

Phone

Address

Alternate Vet (if applicable):

Name and Phone Number of alternate Vet

Pet(s) Covered by this Release

Pet Name(s)

Breed(s)

Medical Concerns or Conditions:

Authorization for Emergency Veterinary Care

In the event of a medical emergency involving my pet(s) while I am away, I authorize Jaxy Cats Pet Services to seek treatment from the veterinarian(s) listed above or an emergency veterinary clinic if needed. I understand that every effort will be made to contact me or my emergency contact prior to treatment, but in the event I am unreachable, I give my full consent for Jaxy Cats Pet Services to approve medical care recommended by a licensed veterinarian.

I accept responsibility for all charges related to any veterinary care and understand that Jaxy Cats Pet Services is not financially liable for the cost of emergency treatment.

Spending Authorization (Initial the option that applies)

I authorize emergency treatment up to $500 without prior approval.

I authorize unlimited emergency treatment as recommended by a licensed veterinarian.

Agreement & Signature

By signing below, I confirm that the information provided is accurate, and I understand and accept the terms of this veterinary release form.

Pet Owner Signature:

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Questions? Contact us at jaxycats1@gmail.com or 480-616-1717