Absent Owner Treatment Form

Going on vacation and leaving your pets behind? Click on the link below to let us know what your wishes are in case your fur babies need care while you are away.

Absent Owner Treatment Form

Name

Pet Name(s)

Email*

Name of person taking care of your pet while you are away.

Phone Number of caregiver

By typing my name the agent stated above is responsible for my pet(s) while I am away and will be able to make all decisions regarding medical care.

For decisions regarding medical care, I wish to be contacted. If I cannot be reached, I appoint the following person to act on my behalf.

By typing my name below, I certify that I am financially responsible for all charges incurred for the treatment of my pet during my absence.

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Better yet, see us in person!

We love our customers, so feel free to visit during normal business hours.

Animal Medical and Surgical Clinic of Wisconsin

1221 Parkwood Drive, Wisconsin Rapids, Wisconsin 54494, United States

(715) 421-2006

Animal Medical and Surgical Clinic of Wisconsin

1221 Parkwood Drive Wisconsin Rapids, WI 54494 US

(715) 421-2006