Name *

First Name

Last Name

Your phone number *

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Spouse/partner number

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Emergency contact *

Someone who can speak/act on your behalf in the event you cannot be reached.

First Name

Last Name

Emergency contact phone *

(###)

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Veterinary phone number *

(###)

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The CDC has reported that while rare, there have been instances of human-to-pet and pet-to-pet transmission of COVID19. I understand that every effort will be made by The Treat Retreat to social distance pets to prevent illness, but there is the potential that my pet could become infected with the COVID19 virus. By voluntarily sending my pet to Treat Retreat, I accept all risks associated with COVID-19 and will not hold The Treat Retreat responsible. *

I agree and understand.