Pawsome Companions Ltd
This form authorises Pawsome Companions Ltd to seek veterinary treatment for your pet in the event of an emergency when you cannot be contacted.
Owner Details
Owner Name: ______________________________________
Address: ________________________________________
Postcode: _______________________________________
Phone Number: ___________________________________
Email Address: __________________________________
Emergency Contact (if owner unavailable): ___________________________
Emergency Contact Phone Number: _________________________________
Pet Details
Pet Name: _______________________________________
Species/Breed: ___________________________________
Age: ____________________________________________
Colour/Identifying Features: _______________________
Microchip Number (if applicable): ___________________
Medical Conditions: ________________________________
Medications: _____________________________________
Allergies: _______________________________________
Veterinary Practice Details
Veterinary Practice Name: ___________________________
Veterinary Address: ________________________________
Veterinary Phone Number: ___________________________
Emergency Treatment Authorisation
I authorise Pawsome Companions Ltd to seek veterinary care for my pet in the event of illness, injury, or emergency if I cannot be contacted immediately.
I understand that every reasonable effort will be made to contact me before any treatment is authorised.
If I cannot be reached, I give permission for Pawsome Companions Ltd to transport my pet to the veterinary practice listed above or to the nearest available veterinary clinic if necessary.
I agree that I am responsible for all veterinary costs incurred.
Transport Consent
I give permission for Pawsome Companions Ltd to transport my pet in a vehicle if veterinary care is required.
☐ Yes
☐ No
Owner Agreement
I confirm that the information provided above is accurate to the best of my knowledge and I grant permission for Pawsome Companions Ltd to act in the best interests of my pet in an emergency situation.
Owner Name: ____________________________________
Owner Signature: _________________________________
Date: __________________________________________