ACKNOWLEDGMENT BY PET OWNER: By submitting this form, I authorize Cathy’s Tender Loving Pet Care to transport my pet to the designated Veterinarian/Animal Hospital listed below if deemed necessary by Cathy’s Tender Loving Pet Care. I further agree that I will provide the necessary credit card information to the Veterinarian/Animal Hospital directly to cover all expenses incurred while in the Veterinarian/Animal Hospital Care. I further understand that it is my responsibility to provide an available phone number(s) for me to be reached in case emergency care is required for my pet. I also understand and agree that Cathy’s Tender Loving Pet Care will not be responsible for any decisions and payments to the Veterinarian/Animal Hospital for diagnosis and care of my pet in my absence. I will contact the Veterinarian/Animal Hospital directly to authorize treatment and provide credit card information directly to the Veterinarian/Animal hospital. I understand and agree that Cathy’s Tender Loving Pet Care will only be responsible for transporting my pet to and from the Veterinarian/Animal Hospital and administering and medications and loving care my pet requires when released by the Veterinarian/Animal Hospital during my absence.
Owner and Date
Pet(s) Name(s)
Emergency Contact 1: Name and Phone Number
Emergency Contact 2: Name and Phone Number
Veterinarian/ Animal Hospital Information: Name, Address, Phone Number