Arden Animal Hospital

1823 Fulton Avenue
Sacramento, CA 95825

(916)485-5412

www.ardenanimalhospital.com

Pet Caretaker Release Form Form

Date that this agreement is valid: (required) :
Please list who has been contacted to care for your pet in your absence: (required)

Important, please read:

Total diagnosis and treatment limit (dollar amount) (required)

Important, please read:

Pet's Name (required)

Pet Description (Color/Breed/Sex) (required)

Pet's Age (required)

Medical Conditions/Medications

If my pet becomes ill/injured/appears to be at significant risk, I request that they be taken to: (required)

Arden Animal Hospital
Sacramento Veterinary Referral Center
Neither


If none of the above work, I authorize my pet be taken to another office for treatment (required)

Yes
No


Emergency Contact Name/Numbers: (required)


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