Emergency Veterinary Authorization

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Client Name *

Pet Name *

To the veteriarians at *

I give total responsibility for the care of my pets to: Waggin' Tails Critter Sitter, LLC, contact number 401-405-6618. When I cannot be contacted immediately, this Company and its owner, along with the vet, will make all decisions regarding necessary treatment in the event of a medical emergency. Initial to agree. *

I wish no more than (see below) to be spent on any one pet. Company will be reimbursed as soon as possible by owner. *

Insured? *

Yes

If any of my pets dies suddenly, I do/do not want a post mortem performed to determine the cause of death. In the event of death, it is my wish: *

I DO want a post mortem performed to determine cause of death

I DO NOT want a post morterm performed to determine cause of death

In the event of sudden death, I would like my pet to be: *

cremated privately

cremated communally

brought home for burial

Other:

Date *

YYYY

Please type your name to verify that you have read, understand and agree to the above agreement *

Submit

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