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Pet Care Emergency Authorization Form

Please complete this form and submit in order to give authorization for an alternative caregiver to make veterinary medical decisions in your absence. If you have any questions please call us or email [email protected].

"*" indicates required fields

Owner & patient details


Alternative Caregiver Information


This would be the date after which the alternative caregiver is no longer authorized to make veterinary medical decisions on your behalf.
MM slash DD slash YYYY

Owner's Consent