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Consent To Have Third Party Pick Up Pet Form

Save time during your next appointment. Complete your consent to have third party pick up pet form online from any device at any time before your visit.

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Consent To Have Third Party Pick Up Pet

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

OR

You may use the PDF version by clicking the DOWNLOAD FORM button and then completing the printed form by hand. Please bring the completed PDF form with you for your pet’s first appointment.

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I agree that I am the legal owner of the following pet and that the following information for me and my pet is correct.

I agree

Client Name: *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone: *

Patient Name: *

Species:

Breed: *

Color: *

Sex: *

DOB:

Age:

I agree that the following person is allowed to pick up my pet from Animal Care Hospital with the stipulated expiration date. *

I agree

Name *

Expiration Date *

Animal Care Hospital agrees that it will require a photo identification of the person you have designated to pick up your pet. *

Click or drag a file to this area to upload.

Signature of Owner *

Clear Signature

Date *

Forms

Consent To Have Third Party Pick Up Pet Form

Consent To Have Third Party Pick Up Pet

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