Surrender Consent Form

Client (Owner) Name
First Last
Pet Name*
Consent:*
- Further, I warrant that I am the legal owner and/or responsible agent of my pet and I have the right to surrender this animal.
- I acknowledge that I forever waive all future rights to visit, to see, to exercise control, or to exercise judgement concerning the treatment or placement of my pet.
- I understand I am not entitled to information concerning the identity of the person who adopts my pet and that I do not have any discretion to approve or disapprove any placement. Tamarack Veterinary Clinic shall have full and complete discretion in any decisions about my pet's future.
- I attest that I have not been coerced into this decision and have made it of my own free will. I feel that my options have been thoroughly explained to me and I choose to surrender my pet instead of euthanizing. I feel that this is the best recourse for my pet at this time.
Signature of Owner*
Date*
Date Format: MM slash DD slash YYYY

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CONTACT

2531 – 17th Street NW
Edmonton, AB
T6T 0Y2

Phone: 780-250-1700
Fax: 780-250-1705
Email: [email protected]

HOURS

Mon, Wed, Fri 8:00am -6:00 pm

Tues, Thurs 8:00 am -8:00pm

Closed Weekends and Holidays

EMERGENCIES

For after-hours please contact either:

Pulse Veterinary Specialists and Emergency
320-450 Ordze Rd Sherwood Park, AB
(780)-570-9999

VCA Guardian Veterinary Emergency and Specialist Centre (780) 436-5880

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