Veterinarian Release Form

* This form is only required if you signed up for day-training.

Client Name*
First Last
Client Address*
Street Address Address Line 2 City State Zip/ Postal Code
Pet(s) name and Age*
If you are signing for more than one pet, please enter all of their names and ages.
Veterinarian's Name*
First Last
Hospital Name*
Hospital Address*
Street Address Address Line 2 City State Zip/ Postal Code
Release Consent*
By checking this box I agree to the terms of this Veterinarian Release form.
During my absence, Christine Young of The Puppy Care Company will be caring for my pet(s). The Puppy Care Company has my permission to transport my pet(s) to your office for treatment. I (client) authorize you to treat my pet(s) and will be responsible for payment to you upon my return.

I give Christine Young permission to transport my pet(s) for care to the above-mentioned veterinarian (or to the closest facility in the event of an emergency). I give permission for the hospital/clinic/doctor to administer whatever care/medications necessary to care for my pet(s), with the exclusion of what is written in the exclusions question box below.
Exclusions (optional):
Signature*
Print Name*
Date*
Date Format: MM slash DD slash YYYY