Legal
Emergency Veterinary Release
Last updated: April 4, 2026.
How To Use This Form
This page is a template for intake and recordkeeping. Bark & Blaze may collect this authorization in paper or electronic form as part of onboarding before services begin.
Purpose
This form authorizes Bark & Blaze to seek veterinary care for a client's pet when the client cannot be reached or when time is critical.
Client And Pet Information
- Client full name: ____________________
- Address: ____________________
- Primary phone: ____________________
- Secondary phone: ____________________
- Email: ____________________
- Pet name(s): ____________________
- Species / breed / age: ____________________
- Known medical conditions / medications / allergies: ____________________
Veterinary Information
- Primary veterinarian / clinic: ____________________
- Clinic phone: ____________________
- Clinic address: ____________________
- Preferred emergency clinic: ____________________
- Emergency clinic phone: ____________________
Emergency Contact
- Name: ____________________
- Relationship: ____________________
- Phone: ____________________
Authorization
I authorize Bark & Blaze to obtain veterinary treatment for my pet when Bark & Blaze reasonably believes treatment is necessary and I cannot be reached in time to direct care, or when delay could materially increase risk to my pet.
I authorize Bark & Blaze to transport my pet to a veterinary provider or emergency clinic if reasonably necessary.
I understand that Bark & Blaze is not a veterinary provider and is not responsible for veterinary outcomes. I agree to remain fully responsible for all veterinary charges, transportation costs, and related expenses incurred on behalf of my pet.
Spending Limit
Optional client spending authorization before additional approval is required, if reasonably possible: $____________________
Signature
Printed name: ____________________
Client signature: ____________________
Date: ____________________
Recordkeeping
Client should keep this authorization current and promptly update Bark & Blaze if veterinarian information, emergency contacts, medical conditions, or spending limits change.