5065 NE Lincoln Rd Poulsbo WA 98370 US
(360) 779-5557

Emergency Contact Authorization Form

Name: Sound Equine Veterinary Hospital
Address: 5065 NE Lincoln Rd, Poulsbo, WA, 98370, US
Telephone: (360) 779-5557

Owner First Name

Owner Last Name

Best Number to Reach you:

Emergency Contacts

First Name

Last Name

Phone Number

First Name

Last Name

Phone Number

In case of emergency I authorize _________ to make Medical decisions for my horse(s)

I am willing to spend up to $

If an end of life decision needs to be made and you are unable to contact me, I authorize ________ to make that decision for me.

Do you have equine insurance?

Yes

If yes, which company do you use, and which horses are covered?

Please list which horses are candidates for Colic Surgery if necessary to save life:

Are you/caretaker able to trailer in an emergency?

Yes

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We'd Love To Hear From You.

Sound Equine Veterinary Hospital accepts new patients, including horses, backyard donkeys and other farm animals. Our tight-knit veterinary team works together and with our clients to achieve the best possible outcomes for the animals you love.

Contact Call (360) 779-5557