Treatment Authorization Form

Owner's Name

If my pet(s) were to become ill or require medical treatment, I would be contacted as soon as possible. In the event I am not reachable, I authorize La Jolla Veterinary Hospital to administer any treatment or medication necessary for the well being of my pet(s).
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Please mark one of the following

Prescription medications, therapeutic diets, and pet supplies are not included in this treatment plan.

E-Signature

Date

rats3898 none 7:30 am - 6:00 pm 7:30 am - 6:00 pm 7:30 am - 6:00 pm 7:30 am - 6:00 pm 7:30 am - 6:00 pm 8:00 am - 5:00 pm Closed veterinarian # # #