OTHER DOCS

VETERINARY RELEASE FORM

Cell Phone Number *

Phone number of above veterinarian (doctor/hospital/clinic) *

Email Address *

VETERINARY RELEASE - THE WEST VILLAGE CAT SITTER & MANHATTAN KITTIES LLC aka WVCS-MK and/or the selected sitters. In the event that any of my cats appear to be ill, injured, or at significant risk of experiencing a medical problem at the start of service or while in the care WVCS-MK and/or the selected sitters, I, THE OWNER (SEE BELOW FOR NAME) give permission to WVVS-MK and/or the selected sitters to seek veterinary service from a veterinarian or a veterinary clinic. NAME OF OWNER *

I ask WVVS-MK and/or the selected sitters to inform the attending clinic or veterinarian of my requested total diagnosis and treatment limit of: AMOUNT PER CAT *

Address of above Veterinarian (doctor/hospital/clinic) *

I understand that efforts will be made to contact me regarding any treatments, illness, injury, or potential problems as soon as the condition is deemed not life threatening and/or contact is possible. I understand that WVCS-MK and/or the selected sitters work hard to prevent accidents and injuries, and that such problems may occur no matter how well a pet is cared for. I agree to allow WVCS-MK and/or the selected sitters to use their best judgment in handling these situations, and I understand that WVCS-MK and/or the selected sitters assume no responsibility for the actions and decisions of the veterinary staff, the health, or death of my cat(s). I will assume full responsibility for the payment and/or reimbursement for any and all veterinary services rendered, including but not limited to diagnosis, treatment, grooming, medical supplies, and boarding. Such payments will be made within 14 days of the initial incident. I also agree to be responsible for all Special Service fees assessed by WVCS-MK and/or the selected sitters for emergency transportation, care, supervision, or hiring of emergency caregivers, and will pay such fees within 14 days of each incident. I further authorize WVCS-MK and/or the selected sitters and my primary veterinarian(s) to share all of the medical records of all of my cats with veterinary clinics in an emergency in the interest of providing the best care for my ill or injured animal(s). Every cat at the site of service will be current (per my veterinarians recommendations) on its rabies vaccinations prior to the arrival of any caregiver. I will also make arrangements to guarantee that each cat will remain current on its rabies vaccinations throughout each service visit period. I agree to notify WVCS-MK and/or the selected sitters of any signs of injury or possible illness before any visit as soon as the condition appears. WVS-MK and/or the selected sitters reserve the right to cancel service at any location where a cat with a potentially infectious condition exists. WVCS-MK and/or the selected sitters strive to provide clean, safe service to each of our clients. In doing so, WVCS-MK and/or the selected sitters strongly recommend that each cat be dewormed and vaccinated according to veterinarian recommended standards. This agreement is valid from the date below and grants permission for future veterinary care without the need for additional authorization each time WVCS-MK and/or the selected sitters care for one or more of my cats. I understand that this agreement applies to all of the cats within WVCS-MK and/or the selected sitters care. In submitting this form, I agree that I have the sole authority to make health, medical, and financial decisions regarding the cats that will be scheduled to receive service. DATE *

MY PREFERRED VETERINARIAN and/or hospital/clinic is: *

NAMES OF CATS *

THE WEST VILLAGE CAT SITTER & MANHATTAN KITTIES LLC™

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