Medical Emergency Instructions

These instructions are intended to provide directions in the event of an emergency.

We request that owners of each pet over 10 years old or those with medical issues complete this form.

This information will remain on file.

It is your responsibility to update this information if anything changes in the future.

Walkers Pet HoTail® Pet Care Center

MEDICAL EMERGENCY INSTRUCTIONS

I authorize Walkers Pet HoTail Pet Care Center to make medical decisions for my pet(s) should they require veterinary/medical care during their stay.

Initials *

I agree that all veterinary/medical services and products incurred by Walkers Pet HoTail will be reimbursed in full on the day of checkout. (The costs and fees associated with these products and services may include, but are not limited to, the cost of medications, vaccinations, administration of medicines, transportation to a different veterinarian facility, as well as isolation and fecal collection fees.)

Initials *

If necessary, I authorize Walkers Pet HoTail to transport our pet(s) to my regular vet if they are open or to another veterinary facility (e.g. AVETS).

Initials *

Except as stated below in “Other Instructions”, I authorize the vet to incur all expenses necessary to treat my pet, and to bill me directly for any required services.

Initials *

On behalf of myself, my executors and heirs I hold Walkers Pet HoTail harmless, and release and indemnify them against any claim for recognizing Walkers Pet HoTail’s authority or for following my treatment instructions in good faith.

Initials *

Owner agrees all services are provided under the terms of the Customer Agreement and Waiver

Initials *

Other Instructions:

(List any treatment or financial restrictions)

If the vet feels euthanasia is appropriate: *

I authorize the vet to proceed
I DO NOT authorize the vet to proceed

Please choose one

In the event my pet passes away, I authorize Walkers to: *

Hold my pet’s remains until I pick them up
Transport my pet’s remains to a vet

Please choose one

If my pet's remains are at a veterinary practice, I authorize the vet to: *

Hold my pet’s remains until I provide instructions
Dispose of the pet’s remains
Cremate my pet’s remains and hold the ashes for me

Please choose one

Owner agrees all services are provided under the terms of the Customer Agreement and Waiver.

These instructions remain in effect for all future visits unless you notify Walkers in writing of any changes.

Pet's Name: *

Owner's Name: *

Pet's Age:

Date: *

If signed electronically, by typing your name above, you agree the same constitutes an electronic signature executed with the intent to sign and to be bound by these terms and conditions.

Version Dated 10/1/2023

These instructions are intended to provide directions in the event of an emergency.

We request that owners of each pet over 10 years old or those with medical issues complete this form.

This information will remain on file.

It is your responsibility to update this information if anything changes in the future.

Walkers Pet HoTail® Pet Care Center

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