Submit the completed form via email to info.to@veclinic.com, or fax it to (805) 371-0690. Alternatively, bring the printed form to our clinic address: 246 Lombard Street, Suite D, Thousand Oaks, California 91360. Ensure that the form is submitted before your planned departure to facilitate smooth care for your pets.

Important dates for this form include ensuring timely submission before your planned travel. For 2024, consider submitting at least two weeks in advance of your trip. In 2025, keep similar timelines to ensure your pets are cared for during your absence.

The purpose of this form is to provide clear guidelines and consent for caregivers who will be responsible for the pet in the owner's absence. It ensures that caregivers have the authority to make veterinary decisions on behalf of the pet owner. Additionally, it outlines financial responsibilities regarding veterinary care.

• 1. Owner's Name: The name of the pet owner.
• 2. Pet Name: The name of the pet needing care.
• 3. Second Pet Name: Optional field for additional pets.
• 4. Phone Number: Primary contact number for the owner.
• 5. Second Phone Number: Optional secondary contact number.
• 6. Departure Date: The date when the owner will leave.
• 7. Return Date: The date when the owner will return.
• 8. Contact Phone Numbers: Phone numbers to be reached during absence.
• 9. Caregiver's Name: Name of the person taking care of the pet.
• 10. Caregiver's Phone Number: Contact number for the caregiver.
• 11. Payment Arrangement: Details on how costs will be handled.
• 12. Owner Signature: Signature of the pet owner.
• 13. Date: The date when the form is signed.

If the form is not submitted, caregivers may not have the necessary authority to make medical decisions. This could lead to delays in providing care for your pet while you are away. Additionally, the veterinarian may be unable to proceed with treatments that require consent.

• Care Delay: In the absence of signed consent, veterinarians may hesitate to take immediate action.
• Lack of Decision-Making Authority: Without the form, caregivers cannot make important decisions regarding care.
• Financial Responsibility Confusion: Unclear payment arrangements might lead to disputes after treatment.

• 1. Traveling Pet Owners: For pet owners going on vacation or business trips.
• 2. Emergency Situations: In case of hospitalization or emergency work commitments.
• 3. Pet Boarding Services: For pet owners who board their pets and need to authorize care.
• 4. Long-term Absences: If owners are away for extended periods needing care arrangement.
• 5. Caregivers' Authorization: To provide caregivers authority during the owner's absence.