Plantation Delight Doggie Day Care

Loving Babies for Loving Homes

PLANTATION DELIGHT

DOGGIE DAY CARE

VETERINARIAN AUTHORIATION FORM

 

VETERINARIAN________________________________________________________

 

PETS NAME____________________________________________________________

 

During my various absences, Plantation Delight will be caring for my animal(s). They have my permission to transport them to and from your office or, incase of large animals, request “on site” treatment from your office as is deemed necessary. I authorize you to treat my animal(s) and I will be fully responsible for all fees and charges and will pay for all charges they incur on my behalf upon my return. I further authorize you to give out any information about m animal(s) to Sandy Reynolds, the owner of Plantation Delight Doggie Day Care.

 

Client Signature: _________________________________________________________

 

Urgent Veterinary Treatment Authorization

This form will be retained on file and will be used to authorize urgent veterinary treatment in the event that your pet(s) require such treatment during your absence and we are unable to contact you at the time. Should you change Vets, please notify Plantation Delight before service dates.

To whom it may concern: I have contracted for services from Plantation Delight Doggie Day Care during my absence and I authorize Plantation Delight Doggie Day Care to act on my behalf to request veterinary treatment and services when they deem it necessary. I accept full responsibility for the charges incurred in the treatment of my pet(s), not to exceed the following amounts for each pet:

Pet Name-Description-Maximum Amount

___________________________________________________________$____________

___________________________________________________________$____________

___________________________________________________________$____________

If multiple pets require treatment, do not exceed a combined total of         $___________

 

Plantation Delight reserves the right to utilize the services of any available veterinary clinic. If time permits, we will attempt to utilize your primary veterinary clinic.

 

I authorize you to treat my animal(s) and I will be fully responsible for all fees and charges and will pay for all charges that are incurred on my behalf, immediately upon my return.

 

__________________________________________                   ___________________

Phone: 610-869-8883 or 484-678-6696

Fax:610-869-3790

E-mail: plantationdelight@comcast.net