Pet SitterAuthorization Form

Please complete our Pet Sitter Authorization Form to ensure your pet can receive seamless, trusted veterinary care in your absence.

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Pet Sitter Authorization Form

Owner’s name:(Required)

Owner’s contact information in case of emergency:(Required)

Dates of travel:(Required)

I give permission for the pet sitter to care for my pet in my absence. He/she has my permission to transport them to and from your clinic or request “on site” treatment from your office as is deemed necessary, and make medical decisions. I further authorize you to give out any information about my pet to those listed below as Authorized People.(Required)

I give permission

Authorized People(s)(Required)

Relationship to pet owner:(Required)

Contact information for authorized agent:(Required)

Add additional authorized people(s)

Yes

Authorized People(s)(Required)

Relationship to pet owner:(Required)

Contact information for authorized agent:(Required)

Animal’s name:(Required)

Type of animal:(Required)

Relevant medical history or chronic medications:(Required)

I authorize emergency veterinary care costs up to:(Required)

$100

$200

$300

$300 +

I accept financial responsibility for the emergency care of the animal(s), and have left my payment information with ABC Veterinary Hospital Pacific Beach. By signing below, I release ABC Veterinary Hospital Pacific Beach and its officers of liability and financial charges accrued on my credit card.(Required)

I understand

I have confirmed the Credit Card on file can be used to process all fees and charges incurred on my pet’s behalf upon the day of service.(Required)

I confirm

Duration of Validity for the above (return date):(Required)

Signature(Required)

Date(Required)

Pet SitterAuthorization Form

Pet Sitter Authorization Form

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