You and Your Vet


Date:

To Whom It May Concern:

Beach Dog Pet Care and any staff veterinarian at Boardwalk Animal Hospital have authorization to make medical decisions regarding the care of my dog, “______________” in my absence from________________to ________________].

Major procedures such as surgical correction of gastric dilatation with volvulus, enterotomy to remove gastrointestinal foreign body, bone plating for fractures, and others are authorized as long as a veterinarian at [one of my trusted facilities] believes there is a reasonable chance the procedure will result in a successful outcome.

I ask to be called on my cell phone at ____-______-______ or  ____-______-______ in the event of any medical problem involving Buster. However, if I cannot be reached then the people listed above shall have decision making power. I agree not to hold any above party liable for competently performed treatments that do not succeed.

Medical bills can be charged to my Visa, MasterCard: _____ _____ _____ _____

Signed, ___________________________________________________