Pet Sitter Emergency Form

Use our Pet-Sitter Emergency Form to provide information on your pet if you are ever out-of town and cannot accompany your pet to IVS.

This form may be used to provide information to IVS care providers when you are not able to accompany your pet to the hospital. Please complete the form to your fullest ability and give it to the person(s) caring for your pet while you are away. When presented to IVS we will use the information given to care for your pet(s) per your request.

Owner's Information

First Owner:

First Name

Last Name

Phone

Second Owner (if applicable):

First Name

Last Name

Phone

Address

Suite/Unit/Apt #

City

State

Zip Code

Pet Information

Name

Breed

Sex

Age

Spayed / Neutered Yes No

Pet's Regular Veterinarian

Clinic Name

Phone

Any Known Medical Issues

Medication(s) the pet is currently taking

Who should IVS contact regarding the care of the pet?

Name

Phone

Pet Sitter Name

Pet Sitter Phone

If the doctors and staff are unable to reach you regarding the care of your pet(s) do you have any specific care instructions?

Payment is due upon services rendered. Who should we contact regarding financial obligations?

Additional Comments or any questions?

Owner Signature - Enter Your Full Name This will serve as your electronic signature.

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