Treatment Consent Form

Fill out our Treatment Consent Form below!

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Complete the form below:

After your form is submitted, we will reach out if we have any questions.

I hereby authorize the following people to present my pet(s) for treatment in my absence should an injury or illness occur to my pet(s) that requires veterinary care. I will provide the following people with a payment method (cash, check, or credit card) to pay the bill at the time of service. *

Print Name

This authorization also includes any medical treatments, anesthesia consents, or surgical procedures needed (and any charges with fees incurred for the above). The total amount should not exceed ($):

I authorize any veterinarian to provide my pet with veterinary care and essential medical service. Do you authorize intensive medical efforts for your pet? *

If the attending veterinarian determines that my pet is suffering and/or is incurably injured, do you consent to euthanasia? Please understand that if your pet's health is this critical, we will try everything in our power to get in contact with you before any decisions are made. *

I will be able to be reached at the following phone number: *

Pet Caretaker #1 *

First

Last

Email *

Phone *

Signature *

Clear Signature

Pet Caretaker #2

First

Last

Phone

Signature

Clear Signature

Date *

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Treatment Consent Form

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We care for the pets of Pampa, TX, and beyond.

We love to take care of your pets, but we specialize in best friends!

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