Emergency Contact & Medical Release Form

Where Dogs Are Family!

Emergency Contact & Medical Release

Please complete, digitally sign, and submit the Emergency Contact and Medical Release Form. 

Waggin' Tail Inn Medical Information and Release
First and Last Name
Dog's Gender *
Is your dog Spayed or Neutered *
Emergency Consent: *
In the event of a medical emergency, I give Evonne Kucera of the Waggin’ Tail Inn permission to seek necessary veterinary care for my dog, listed above.
I understand that I will be consulted before care is sought if possible and that I will be notified at the earliest possibility.
I also understand that I will be responsible for the cost of necessary care.