Authorization to Provide Care

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Client Information

Address*















Pet Information

Species*


Sex*




I hereby certify that I am the owner of the above-name animal or am an authorized responsible party for him/her and have the authority to execute this consent.

I hereby authorize the performance of the following procedure(s):

I understand that my pet may be transferred to or from Animal Focus Vet at Marks and Animal Focus Vet at Last Vegas Animal Emergency pet transport if needed and I authorize the receiving hospital to provide care as well.

I agree to indemnify and hold Animal Focus Vet – Marks harmless from and against any and all liability arising out of the performance of any of the procedures referred to above or from any liabilities in transportation internally or from a third party.

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