This form will be retained on file and will be used to authorize veterinary treatment in the event that your pet(s) require treatment during your absence, and we are unable to contact you at the time. Should you change Veterinarians, please notify Barks and Blooms
To whom it may concern: During my absence, a representative of Barks and Blooms will be caring for my pets. I give Barks and Blooms my permission to transport my pets to my veterinarian (or an emergency clinic). In the event I cannot be reached, I authorize Barks and Blooms to act as an agent on my behalf regarding my pets’ medical care. I accept full responsibility for charges incurred in the treatment of my pet(s), not to exceed the following amounts
Animal $
Barks and Blooms reserve the right to utilize the services of any available clinic. We will attempt to utilize your primary care clinic.
I authorize veterinary treatment for my animal(s) during my absence. I understand that Barks and Blooms assume no responsibility for the loss of any pet and are released from liability related to transportation, treatment, and expense. I will be responsible for any and all charges incurred during the treatment of my pets limited to the condition of the authorization.
