Contact InformationPet Owner: [Owner’s Name] Date Completed: [Date]Address: [Street Address] [City, State, Zip]Phone: [Phone]E-Mail: [Email address]___________________________________________________Guardian’s Contact InformationPet Guardian: [Guardian’s Name] Address: [Street Address] [City, State, Zip]Phone: [Phone]E-Mail: [Email address]___________________________________________________

Executor of Will Contact InformationExecutor of Will: [Executor’s Name] Address: [Street Address] [City, State, Zip]Phone: [Phone]E-Mail: [Email address]___________________________________________________

Veterinarian’s Contact Information Veterinarian: [Veterinarian’s Name] Address: [Street Address] [City, State, Zip]Phone: [Phone]E-Mail: [Email address]___________________________________________________

Pet Sitter’s Contact InformationPet Sitter: [Pet Sitter’s Name] Address: [Street Address] [City, State, Zip]Phone: [Phone]E-Mail: [Email address] ___________________________________________________

Groomer’s Contact Information Groomer: [Groomer’s Name] Address: [Street Address] [City, State, Zip]Phone: [Phone]E-Mail: [Email address]

Other Family Members

My pet has other family members who they have bonded with. A similar document has been prepared for that pet, and it would be my desire that they maintain their close relationship by staying together if I am no longer able to care for them.

Name of Companion Pet: [Pet’s Name]

Species: [Species]

Breed: [Breed]

Color: [Color] DOB: [Date of Birth]

[PET NAME][PET’S OTHER NAMES, IF ANY]

PET CARE PLANTHIS DOCUMENT CONTAINS IMPORTANT INFORMATION

AND INSTRUCTIONS FOR THECARE OF MY PET.

IT IS NOT A LEGALLY BINDING DOCUMENT AND IS ONLY

INTENDED TO HELP MY PETGUARDIAN PROVIDE PROPER

CARE FOR MY PET.

The location where vaccine records, health records, and county licenses on my pets can be found is: [Location of Records]

Description of PetPet Name: [Pet’s Name]

Species: [Species] DOB: [Date of Birth]

Breed: [Breed] Color: [Color]

Spayed/Neutered: ☐Yes ☐No

Distinctive markings: [Markings]

Brand of Food: [Food]

Feeding Info: [Frequency & Quantity]

Food Allergies: [Food Allergies]

Medications: [Medications]

Weight: [Weight]

Housetrained: : ☐Yes ☐No

No Crate Trained: : ☐Yes ☐No

Diseases & Injuries: [Diseases & Injuries]

Behavioral Issues: [Biting, Snapping, or any other behavioral issues]

[PET NAME][PET’s OTHER NAMES, IF ANY]

Medical Decisions (Check Only 1 Below)

☐ I want my pets to receive all medical treatments available to treat any disease, illness or injury they have, including but not limited to, chemotherapy, radiation, acupuncture, massage therapy, dialysis, etc.

☐ I want my Pet Guardian to use his or her discretion and best judgment in determining the type of veterinary care, medications, and medical treatments my pets should receive, taking into consideration the amount of suffering my pet will endure, the likelihood such care, medication or treatment will improve my pet’s longevity and quality of life, and the recommendation of the treating veterinarian.

☐ I want my Pet Guardian to ensure my pets receive routine veterinary examinations, medications, pain relievers, vaccinations, preventative medications, steroidal treatments, antibiotics, and surgeries as recommended by the treating veterinarian. However, I do not want my pets subjected to chemotherapy, radiation, dialysis or similar types of treatment that could put my pets through unnecessary pain and suffering that may outweigh the benefits. My Pet Guardian should follow the recommendation of the treating veterinarian to ensure my pet is comfortable and does not experience unnecessary pain. If my pet is experiencing a significant amount of pain that cannot be relieved with medications, my Pet Guardian should use his or her discretion and best

Last Wishes (Check Only 1 Below)

After their death, I prefer my pet be:

☐ Buried. I made arrangements for my pets to be buried at: [Additional Info]

☐ Buried. I have not made arrangements for the burial of my pets and leave this decision to my Pet Guardian.

☐ Cremated. I want their ashes stored as follows: [Additional Info]