RRK9 Veterinary Consent Form

Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

You can contact me at *

or you may get a hold of my emergency contact *

at *

Your Pet's Name *

Primary Vet Information

Name of Clinic *

Phone *

Please provide your pet’s current vaccination records with your paperwork

Click or drag a file to this area to upload.

Does your dog have any allergies or any other medical concerns that we should be made aware of? *

Yes
No

If yes, explain:

I give Red River K9 II LLC permission to take my dog(s) that are listed above, to the clinic registered on file with Red River K9 II LLC. If it is more convenient, I give permission to Red River K9 II LLC to take my dog(s) to the nearest veterinary clinic for medical treatment in my absence. I agree to pay all charges associated with a visit to the vet.

Only as a last resort, I give permission to have my dog(s) taken to the Green Bay Emergency Center. I agree to pay all charges associated with a visit to the GBEC.

My dog(s) has the following existing injury/injuries and/or allergy/allergies listed below.

If my dog(s) become ill or if the state of the dog(s) health otherwise requires professional attention, Red River K9 II LLC, in its sole discretion, may engage the services of a veterinarian or administer medicine or give other requisite attention to the dog(s), and the expenses thereof shall be paid by the pet owner. *

I authorize the use of appropriate anesthesia and pain relief medication as needed before or after the procedure. I have been informed that there are risks associated with the use of any medications. *

I agree to pay all costs and charges for special services requested due to the above listed injuries and/or allergies and all veterinary costs for the dog(s) during the time said dog(s) is in the care of Red River K9 II LLC. *

I further agree that the dog(s) shall not leave Red River K9 II LLC until all charges are paid to Red River K9 II LLC by the Owner of said dog(s). *

Signature *

Clear Signature

This Veterinary Consent Form contains the entire agreement between the below signed parties. All terms and conditions of this contract shall be binding and the heirs, administrators, personal representatives and assigns of Owner and Red River K9 II LLC.

Today's Date *

FORMS

Red River K9 II LLC Veterinary Consent Form

Primary Vet Information