Consent to Care: This section is required for your pet to receive service
By signing this form, I give permission for my pet(s) to be examined and vaccinated by the volunteer staff. I acknowledge that such vaccines do not constitute complete health care. I understand it is essential that my pet(s) receive at least a yearly physical examination. I understand that vaccinations may cause rare reactions in pets. I also agree to accept all risks of vaccination and personally accept both legal and financial responsibility for all charges incurred because of all such risks. I also accept that it is my responsibility to seek emergency care as needed and directed. It is also my responsibility to save any documents given to me by this free clinic to document my pet(s) vaccination history as the organization does not guarantee proof of services received after the date received.
Owner Certification
I certify that, to the best of my knowledge, my animal is free of known contagious or infectious diseases and is not immunocompromised. I understand that I am responsible for providing accurate and complete information regarding my animal's health history and that vaccination decisions should be discussed with a veterinarian when there are known health concerns, pregnancy, previous vaccine reactions, or other risk factors.