HAYMARKET VETERINARY SERVICE equine ambulatory P O Box 1005-2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the Horse Owner Information section. Enter your name, address, city, state, zip code, cell number, home number, and email address. Ensure all details are accurate for effective communication.
3. If applicable, complete the Lessee Information section with the lessee's name and contact details. This is crucial for any shared responsibilities regarding veterinary services.
4. List each horse under the Horse section. Include their names, registered/show names, date of birth (DOB), breed, color, gender, and stable/boarding location. This information helps tailor services to each horse's needs.
5. In the Authorized Agent section, indicate if you authorize an agent to make appointments and order medications on your behalf by checking 'YES' or 'NO'. Fill in their name and phone number if applicable.
6. Review and initial the Services section to authorize routine and emergency care for your horses. This confirms your consent for necessary treatments.
7. Select your payment preference from the options provided. If you choose credit card payment, fill in the required credit card information accurately.
8. Finally, sign and date the agreement at the bottom of the form to confirm your understanding and acceptance of its terms.

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