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541-388-0262
541-388-0262
Pet Sitter Authorization Form
By filling out and submitting this form, you are authorizing the party who is caring for your pets to bring your pets to us in the instance of any care needs.
During my absence,
Pet Sitter's Name
*
First
Last
will be caring for my animal(s),
Insert Pet's Names Here
*
They have my permission to bring them in for treatment as deemed necessary. I authorize you, the doctors and staff of Bend Veterinary Clinic to treat my animals ad I will be fully responsible for all fees and charges. I will pay for all charges incurred on my behalf upon my return. I further authorize you to give out any information regarding the care/treatment of my animal(s) to the pet sitter named above.
Urgent Veterinary Treatment Authorization
Client Name
*
First
Last
Address
*
Street Address
City
State
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Alaska
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California
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Connecticut
Delaware
District of Columbia
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Armed Forces Americas
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ZIP Code
Phone
*
Cell Phone (if different than above)
Email
*
Special Instructions
Maximum Amount for Urgent Care Services (if any):
Pet Sitter Information
Name
First
Last
Home Phone
*
Cell Phone (if different than Home Phone)
Work Phone
*
By submitting this form, I am authorizing Bend Veterinary Clinic to treat my animal(s). I acknowledge that I will be responsible for all fees and charges and will pay in full upon my return.
Services
Services for Dogs
Services for Cats
Services For Pocket Pets
What to Expect on your Visit
Payment Options
Wellness Plans
About Us
Doctors & Staff
Contact
New Client Forms
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