Owner Information Form

Owner’s Name: __________________________________________________________________

Address: ____________________________________________________________

City: ____________________________Zip Code: ____________________________

Home Phone: _________________________________

Cell: _______________________________________

Email:______________________________________

Veterinarian: _______________________________________________________________________

Veterinarian’s Address & Phone Number: _______________________________________________________________________

Emergency Contact Person: _______________________________________________________________________

Emergency Contact Number: _______________________________________________________________________

Medical Emergency Veterinary Release Form

Permission is given to Cats Inn on the Chagrin (CI) to transport my animal to a Veterinarian in a vehicle and I release them from all responsibility in case of injury/death due to an automobile accident. Please indicate the type of medical care you would prefer for your pet in case of illness or injury:

Basic Care: Minimal care to relieve pain and suffering

Full Service Care: Exam, X-Rays, Lab Tests, IV Therapy and/or treatment necessary for your pet(s) _______________________

Amount of money I would be willing to spend $___________________

CI does agree to provide boarding services for your pet(s) in a reliable and trustworthy manner. In consideration of these services and as an express condition thereof, the Owner of the pet(s) understand that CI and its employees cannot be held liable for illness or injury to your pet(s). We will do everything in our power to ensure that your pet(s) has a safe and healthy experience at CI. Pre-existing medical conditions, Acts of God, or any other event beyond our control can cause emergency situations and we cannot be held liable for their outcome. CI has the authority to take the pet(s) to the Veterinarian if necessary and the client agrees to pay all charges incurred.

Signature indicating agreement______________________________________

Date_____/____/___________