Animal Humane Society
Rescue consent form for wellness services
Name of requestor:
Name of rescue organization:
Patient's name and any aliases that foster may be using for the pet:
We cannot provide any services (except microchipping, nail trimming, or anal gland expression) or medications to patients we have not examined before, so an examination and exam fee will be part of the services for new patients.
Are there any particular concerns the doctors should address in examination?:
Do Not Fill This Out