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Hours 4700 42nd Ave SW #210
Seattle, WA 98116

Pet Sitter Authorization

Pet Sitter Information

Pet Sitter Name*

Pet Sitter Phone*

Second Pet Sitter Name

Second Pet Sitter Phone

Consent

I authorize the West Seattle Animal Hospital to perform the recommended veterinary treatment(s) on my pet(s) at the discretion of the above-mentioned pet sitter(s). The sitter(s) is to act as my agent(s) to make any decisions regarding treatment(s) that are best suited to my pet's condition, up to and including euthanasia if necessary, if my pet should require medical treatment during my absence. I further authorize West Seattle Animal Hospital to give any information regarding the care/treatment of my animal(s) to the sitter mentioned above.

Payment
I accept full responsibility for all charges incurred in the treatment of my pet and I agree to pay the fees for any veterinary services by leaving payment with my pet sitter(s) or by using a credit card number kept securely on file with The West Seattle Animal Hospital.(fill in amount and initial below)

I authorize treatment costs of up to:
I have made arrangements with my pet sitter to pay and I will reimburse them accordingly.
I have made arrangements with your office for payment by credit card authorization on file.*

Special Instructions

Signature (I certify that I am the owner of the above mentioned pet and consent to all items on this form.)*

I Agree

I Disagree

*If you haven't already done so, please contact our office to make arrangements to fill out a Credit Card Authorization form.

West Seattle Animal Hospital