Vacation Consent Form

In the event of a medical emergency involving my horse(s), every effort should be made to contact me regarding my horse’s current situation.

To facilitate this I have left a copy of phone numbers where I can be reached throughout my vacation / leave as well as the length of stay with both the people watching my horse(s) as well my veterinarian.

If, however, decisions need to be made procedures need to be performed in my absence, please use this form as a guideline.
I, Invalid Input as the owner of the horse(s)

**please include both registered names and nick names
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which are stabled at Invalid Input

do give my permission to Christi Garfinkel DVM,  to perform services on the above named horses in my absence.

If the emergency is more severe, Dr. Garfinkel may use her best judgement in determining if my horse can be saved within a reasonable medical probability and financial practicality with a cost cap of $ Invalid Input .

I agree to assume full financial responsibility for these services.

If Christi Garfinkel DVM determine that my horse can not be saved due to the severity of the condition and/or financial constraints, I hereby authorize them to euthanize my horse for humane reasons.

Any additional comments:
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Signature of Owner Invalid Input  **Please enter your month of birth in lieu of your signature.

Email of Owner Invalid Input

Date

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