Authorization for Comfort Care Owner's Name(Required) First Last Pet's Name(Required)Please read, acknowledge, and check each of the following boxes as your digital consent:(Required) I certify I am the legal owner/authorized agent for the owner of the companion animal described above and give Paws Into Grace, and any authorized agents, staff, or representatives full and complete authority to examine, prescribe for and/or treat (“comfort care”) the above described companion animal. I agree that Paws Into Grace, and any authorized agents, staff, or representatives shall not be liable for any direct, indirect, or consequential damages resulting from such comfort care. I understand comfort care is focused on preserving quality of life for as long as possible and is NOT focused on curing medical conditions or providing routine veterinary care, surgical care and/or emergency treatment/transport. I assume full responsibility for the actions of the companion animal described above and all charges incurred during his/her comfort care. I also understand all professional fees are due at the time comfort care services are rendered. I have carefully read and fully understand the above provisions. I certify I am the legal owner or authorized agent for the owner of the pet described above and give Paws into Grace and any authorized agents, staff or representatives full and complete authority to provide services for my pet. I forever release and hold harmless Paws into Grace and any authorized agents, staff or representatives from any and all liability. I/We agree to release and indemnify Paws into Grace, the Veterinarian, and their owners, members, officers, directors, agents, and employees, from any claim, liability, cost, or expense resulting from their reliance on or services or other performance consistent with the directions, declarations, representations, authorizations, and agreements herein. I/we understand that incorrect usage, including accidental injection, of the treatment patch prescribed, may cause illness up to and including death, which I acknowledge Paws into Grace is not liable for. Select AllPaws Into Grace has informed me if additional diagnostics, procedures and/or more aggressive comfort care are recommended for my companion animal at this time, and I have (check one):(Required) DECLINED additional diagnostics, procedures and/or more aggressive comfort care. ACCEPTED the recommendation(s), and Paws Into Grace has made necessary referrals. Name(Required) First Last Consent(Required) Checking this box serves as my digital signature.Date(Required) MM slash DD slash YYYY
