Please provide name(s) of anyone else authorized to pick up my pet, other than your Spouse (Please note, PPH will not release your pet to anyone without specific permission to do so):
EMERGENCY CONTACT INFORMATION
REGULAR VETERINARIAN INFORMATION
My signature below is in acknowledgement of the following (please read carefully):
EMERGENCY CONSENT TO TREAT
Pet Palace Hotels will make every effort to contact you or your Responsible Party in the event of an emergency. Our primary concern is ensuring your pet’s comfort and his/her ability to receive rapid medical treatment should problems occur.
_(SIGN INITIALS BELOW)_ I give my permission to have Pet Palace Hotels take initial measures to treat my pet for any medical issue(s) that should occur. If standard protocols do not correct the problem and an exam with the veterinarian is indicated, I authorize the on-call veterinarian to treat my pet based on their professional recommendations and I accept full financial responsibility.
The above conditions have been explained to me and I understand that I am responsible for all costs incurred for any exams, diagnostics and treatments provided. Furthermore, I authorize Pet Palace Hotels (and/or authorized agents) to transport my pet to a veterinarian Pet Palace Hotels chooses for treatment including, but not limited to, emergency services or routine care, such as vaccinations, if necessary. I understand unforeseen circumstances can and do arise and do hereby release Pet Palace Hotels, the veterinarian and staff from being held liable for any injury or death to my pet during transportation and/or treatments.
YOUR PET INFORMATION
Please List Any Medication Your Pet Takes Regularly
Please Check All That Apply