Treatment Authorization
Form for Pet-sitter

Name: Melrose Veterinary Hospital
Address: 1680 South Melrose Dr. Suite 104, Vista, CA, 92081, United States
Telephone: +1-760-727-5151
Price range: $

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Owner’s Information:

Owner’s Name: *

First

Last

Name and phone number of person to contact in case of emergency:

Name *

Contact Number *

Pet Sitter’s Information:

Name

First

Last

Contact Number *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Authorizations

I wish to be contacted before any treatment is performed.
There is no need to contact me for treatments costing up to the allotted amount.
In the unfortunate event of death, what are your preferences concerning aftercare?
Circle of life cremation (ashes will be returned)
Communal cremation (ashes will not be returned)
Please hold until I return and I will pick up the body.

Email *

Today's Date *

Phone

Treatment Authorization
Form for Pet-sitter

Owner’s Information:

Pet Sitter’s Information:

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Questions?

Location

Contact Information

Hours

Treatment AuthorizationForm for Pet-sitter

Owner’s Information:

Pet Sitter’s Information:

Treatment Authorization
Form for Pet-sitter