Medical Release Form - Midlothian Resort


Holiday Barn Pet Resorts

Medical Release Form

I/We, of , am/are the owner/have legal custody of the Pets, , who reside(s) with me/us at the address set forth above.

IN CASE OF AN EMERGENCY, I/WE authorize Holiday Barn Pet Resorts, in whose care the Pet(s) has been entrusted, to present such Pet(s) to an approved medical treatment center, and do consent to an X-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care, to be rendered to the Pet under the Veterinarian or Veterinarian surgeon licensed to practice in any state of the United States.

This release is valid for one year from December 4, 2024.

All pet boarding establishments in Virginia are required to present to the consumer the following notice:

STATE OF VIRGINIA LAW
NOTICE

The boarding of animals is subject to Article 3.1 (S3.1-796.83:1 et seq.) of Chapter 27.4 of Title 3.1. If your
animal becomes ill or injured while in the custody of the boarding establishment, the boarding establishment shall provide the animal with emergency veterinary treatment for the illness or injury.

The consumer shall bear the reasonable and necessary cost of emergency veterinary treatment for any illness or injury occurring while the animal is in the custody of the boarding establishment. The boarding establishment shall bear the expense of veterinary treatment for any injury the animal sustains while at the boarding establishment if the injury resulted from the establishment’s failure, whether accidental or intentional, to provide the care required by S3.1 - 796.68; however, boarding establishments shall not be required to bear the cost of veterinary treatment for injuries resulting from the animal’s self-mutilation.

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Document name: Medical Release Form - Midlothian Resort
lock iconUnique Document ID: 1fe64702064145585dbb27491359b1c6f9bfd063
Timestamp Audit
June 17, 2020 4:28 pm ESTMedical Release Form - Midlothian Resort Uploaded by Customer Experience - do-not-reply@holidaybarn.com IP 71.63.85.40
June 22, 2020 1:08 pm ESTMartha Prideaux - mprideaux@holidaybarn.com added by Dawn Lawyer - dlawyer@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40
June 22, 2020 1:08 pm ESTDawn Marie - w72a25@yahoo.com added by Dawn Lawyer - dlawyer@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40
June 25, 2020 9:56 am ESTDawn Lawyer - dlawyer@holidaybarn.com added by Customer Experience - do-not-reply@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40
June 25, 2020 11:15 am ESTDawn Lawyer - dlawyer@holidaybarn.com added by Customer Experience - do-not-reply@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40
June 25, 2020 3:15 pm ESTMartha Prideaux - mprideaux@holidaybarn.com added by Customer Experience - do-not-reply@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40
June 29, 2020 9:09 am ESTCarl Searston - csearston@holidaybarn.com added by Customer Experience - do-not-reply@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40
June 29, 2020 9:09 am ESTReservation Specialist - reservation.specialist2@holidaybarn.com added by Customer Experience - do-not-reply@holidaybarn.com as a CC'd Recipient Ip: 71.63.85.40