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Veterinary Treatment Consent

This form records whether the undersigned pet owner or authorized guardian (“Owner”) authorizes Pawsitive Walkers, LLC (“Pawsitive Walkers”) to arrange veterinary care for the dog identified below. Complete a separate authorization for each dog.

1. Authorization and Emergency Contact

Authority is granted only if the Owner selects “I authorize” below. A signature alone does not grant permission. If the Owner declines, Pawsitive Walkers has no authority under this form to approve treatment on the Owner’s behalf.

If illness, injury, or a medical emergency occurs, Pawsitive Walkers will promptly attempt to contact the Owner using the telephone number and email provided. A backup contact may be contacted to help reach the Owner; listing that person does not authorize them to approve treatment.

If the Owner cannot be reached promptly and has authorized care, Pawsitive Walkers may arrange transport and approve veterinary evaluation and treatment within the spending limit and instructions selected below. The preferred clinic will be used when available and appropriate. If it is closed, unavailable, or reaching it would delay urgent care, Pawsitive Walkers may use another licensed veterinary clinic or emergency hospital.

2. Spending Limit and Financial Responsibility

The Owner must state a spending limit in US dollars per emergency and select instructions for costs exceeding that limit. No amount is preselected. Pawsitive Walkers must obtain the Owner’s direct approval before exceeding the limit, unless the Owner expressly selects the option authorizing minimum additional care that a licensed veterinarian considers immediately necessary to prevent death or serious harm. That option authorizes only the minimum immediately necessary care, not unrestricted treatment, and does not override the exceptions in Section 3.

The Owner is responsible for reasonable veterinary and transport costs authorized under this form or separately approved by the Owner. Pawsitive Walkers will provide invoices and receipts for expenses paid on the Owner’s behalf. Reimbursement is due within 7 days of receipt. Additional approval and attempts to contact the Owner will be documented.

3. Clinical Decisions and Exceptions

Diagnosis, treatment recommendations, and clinical decisions are made by the attending licensed veterinarian. Pawsitive Walkers may arrange and authorize care only within the authority expressly granted by the Owner.

Euthanasia requires the Owner’s direct and explicit written or verbal consent, documented by the veterinarian. This form never authorizes Pawsitive Walkers to consent to euthanasia.

Amputation or another procedure resulting in permanent physical alteration requires the Owner’s direct consent unless the attending licensed veterinarian determines and documents that delay poses a direct and immediate threat to the dog’s life. Any such emergency treatment remains subject to the Owner’s spending instructions and authorization above.

4. Responsibility and Limited Release

To the extent permitted by applicable law, the Owner releases Pawsitive Walkers and its representatives from claims arising solely from good-faith actions taken within the Owner’s express authorization under this form. This release does not cover negligence, reckless or intentional misconduct, unlawful acts, actions outside the authorization granted, or rights that cannot legally be waived. Veterinary outcomes cannot be guaranteed.

5. Acknowledgment and Decision

Please select whether you authorize care. If you authorize care, complete both spending questions. Your selection, spending instructions, and any additional restrictions apply only to the dog identified in this form. Additional instructions do not expand the authority granted above.

Please select one:

I authorize Pawsitive Walkers to make veterinary treatment decisions on my behalf as outlined above.

I do not authorize Pawsitive Walkers to make any veterinary treatment decisions on my behalf. I understand that failure to provide timely instructions may result in delays in treatment.

6. Owner Information

Dog's Name

Complete one authorization for each dog. Use the same name as the dog's individual pet profile.

Owner's Name

Owner's email

Emergency Contact Number

Veterinary Clinic's Name

Veterinary Clinic Address

Veterinarian's name

Veterinary clinic phone

Veterinary clinic email

Preferred emergency hospital

Emergency hospital phone

Emergency hospital address

Alternate contact name

Alternate contact phone

Alternate contact relationship

An alternate contact is a backup contact only; this field does not grant authority to approve treatment.

Medical conditions and allergies

Current medications and doses

Additional emergency instructions

Date

By typing my full name below, I confirm that I am the owner or authorized guardian of the dog identified above, that I have read this form, and that my authorization or refusal is the option I selected. My typed name serves as my electronic signature. No authorization is inferred from a blank response.