Pet Emergency Care form

We will have this form available for a signature when we pick up your pet(s).

EXPRESS PET MOVERS
2701 Elmwood Dr., Bryan,
Texas 77802
(979) 589-1744
AUTHORIZATION FOR EMERGENCY CARE


Client's Name:_______________________________________________________

Address:____________________________________________________________

Phone #:______________________________ Phone # 2:_____________________


Description of pet(s):___________________________________________________

___________________________________________________________________

___________________________________________________________________

Pet's Name(s):________________________________________________________

In the event the above described pet(s) should become ill or injured and should require
veterinary care, I, __________________________, as the responsible party, do authorize
EXPRESS PET MOVERS to take the pet(s) to a licensed veterinarian for treatment. I will take full
financial responsibility for all bills incurred not to exceed $___________________________.

If EXPRESS PET MOVERS is unable to reach me, I authorize them to make any emergency
decision they deem necessary for the well being of the pet(s).

By signing below, I certify that I have read and understand this document. I agree to hold
EXPRESS PET MOVERS harmless for any illness or injury of my pet incurred during or after the
transport of my pet.

Client Name:_________________________________ Date:______________________
(Signature)

We will have this form available for a signature when we pick up your pet(s).