Medical Authorization
To My Veterinarian and Authorized Caregivers
From: {AuthorizedBty:value}
You are receiving this authorization because you are either my veterinarian or an authorized caregiver in my absence.
I will not be available to provide care to my animals from {DepartureDate:value} to {ReturnDate:value}. I will be on a {TypeTrip:value} trip. {OutOfCountry:value}
During this time I am authorizing the following persons to provide care for {AbimalsBeingCaredFor:value};
{AuthorizedCaregiver1:label}
{AuthorizedCaregiver1:value}
{Phone1:label}: {Phone1:value}
{Caregiver1Email:label}: {Caregiver1Email:value}
{AuthorizedCaregiver2:label}
{AuthorizedCaregiver2:value}
{Phone2:label}: {Phone2:value}
{Caregiver2Email:label}: {Caregiver2Email:value}
{AuthorizedCaregiver3:label}
{AuthorizedCaregiver3:value}
{Phone3:label}: {Phone3:value}
{Caregiver3Email:label}: {Caregiver3Email:value}
{VeterinarianEmail:label}
{VeterinarianEmail:value}
{VeterinaryInstructions:label}
{VeterinaryInstructions:value}
{AuthorizedSpendingLimit:label}
{AuthorizedSpendingLimit:value}
My Contact Information
My Contact Phone Number while away is {OwnerContactPhone1:value}.
An alternate phone number for me while away is {OwnerContactPhone2:value}
My Email Address is:{MyEmail:value}
Thank you for your assistance while I am not available and thank you for caring for my animal(s).
