MEDICAL WAIVER ()


Two Dogs & A Goat Incorporated
(the "Company") agrees to administer medication to my pet _______________________________(name of pet). My animal is presently under the care of ___________________________________(name of veterinarian) who has prescribed ___________________________________ (medication) for ______________________________________ (condition).

I have explained dispensing information and the effects of this medication to the pet sitter and the Company. Attached please find dispensing instructions and emergency information.

I acknowledge that the Company services will be performed in accordance with my instructions contained herein. I waive any claim against Two Dogs & A Goat Incorporated unless the Company is negligent and does not perform as agreed herein.

CLIENT:
_______________________________________
DATE:
_______________________________________



Instructions For Dispensing Medications and Emergency Information:

_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

362 Broome Street, #20• New York, NY 10013 • Phone 212-966-5225 • Fax 888- 492-3452
email: char@twodogsandagoat.com

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