Pet Care During Holiday Form

DD slash MM slash YYYY
DD slash MM slash YYYY

Owner Information:

Caregiver's Information:

Emergency Contact (if different from caregiver):

Veterinary Care Instructions

Preferred Clinic for Emergencies:
Authorisation for Veterinary Care:While I am away, I authorise the caregiver listed above to act on my behalf in all decisions relating to my pet’s care, including emergency treatment.
(Please specify the amount you are willing to spend in case of an unforeseen emergency)

Special Instructions