Express Pet Transport, L.L.C.
2604 Rustling Oaks
Bryan, Texas 77802
(979) 219-3686
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 Transport, L.L.C. 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 Transport, L.L.C. 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 Transport, L.L.C. harmless for any illness or injury of my
pet incurred during or after the
transport of my pet.
Client Name:_________________________________
Date:______________________
(Signature)