About this template
Pulsed Electromagnetic Field (PEMF) therapy offers incredible benefits for animals, but providing specialized alternative treatments requires clear communication regarding risks, expectations, and liability. This Animal PEMF Liability Release and Waiver Form template is designed for animal wellness practitioners, equine therapists, and holistic veterinarians who need a streamlined way to gather client contact information, animal details, and legally sound acknowledgments before administering care.
The form systematically captures essential client details alongside specific information about the animals being treated—whether horses, dogs, cats, or other pets. It ensures clients understand the nature of PEMF therapy, acknowledge any inherent risks, and formally release the practitioner from unforeseen complications. By utilizing Doc2Form to turn this template into an easily accessible Google Form, practitioners can effortlessly collect digital sign-offs before every session, keeping operations organized and secure.
Collecting these acknowledgments digitally eliminates messy paperwork and ensures you have a timestamped record of client consent for every animal in your care. Whether you travel to stables, barns, or client homes, this template provides a professional onboarding experience that builds trust and protects your practice.
Key features
- Collect client contact and emergency details in one organized step.
- Log multiple animals per submission with dedicated fields.
- Secure clear liability acknowledgments prior to administering PEMF therapy.
- Easily accessible on mobile devices for barnside or clinic use.
- Built using Doc2Form for instant deployment to Google Forms.
Use cases
Equine PEMF therapists treating horses at competitive stables and boa…
Equine PEMF therapists treating horses at competitive stables and boarding facilities.
Holistic canine practitioners offering mobile rehabilitation and well…
Holistic canine practitioners offering mobile rehabilitation and wellness sessions.
Animal wellness providers updating annual client agreements and risk …
Animal wellness providers updating annual client agreements and risk disclosures.
What this form collects
- Client Full Name (Short answer)Enter your first and last name as the owner or authorized agent.
- Email Address (Short answer)We will use this to send a copy of your submission and session notes.
- Phone Number (Short answer)Best number to reach you regarding appointment details or emergencies.
- Residential or Stable Address (Paragraph)Where are the animals located for treatment?
- Animal Treatment Status (Multiple choice)Is this your first time receiving PEMF therapy with us?
- Primary Animal Type (Dropdown)Select the primary species receiving treatment.
- Animal Name and Details (Patient 1) (Paragraph)Provide the name, age, breed, and any relevant medical history for the first animal.
- Animal Name and Details (Patient 2 - Optional) (Paragraph)If applicable, provide details for a second animal receiving treatment.
- Animal Name and Details (Patient 3 - Optional) (Paragraph)If applicable, provide details for a third animal receiving treatment.
- Veterinary Clearance (Multiple choice)Has the animal received clearance from a licensed veterinarian for complementary bodywork or PEMF therapy?
- Liability Release & Waiver Acknowledgment (Multiple choice)I understand that PEMF therapy is a complementary modality and does not replace traditional veterinary medicine. I hereby release the practitioner and company from any liability regarding unexpected outcomes.
- Client Electronic Signature (Short answer)Type your full legal name to serve as your electronic signature confirming agreement to this waiver.
- Veterinary Records or Referral Link (Paragraph)Please paste a link to any relevant veterinary notes or documents (Google Drive, Dropbox, etc.) or describe them here.
FAQ
How do I customize the liability text for my specific practice?
Once you convert this template into Google Forms using Doc2Form, you can easily edit the section descriptions and question text to include your specific legal verging and business terms.
Can clients complete this form on their smartphones?
Yes! Google Forms are fully responsive, allowing clients or pet owners to fill out and submit the waiver right from their phones while standing right next to you.
How do I handle client signatures?
While Google Forms does not feature a native digital signature pad, you can use a text field for clients to type their full legal name as an electronic signature, or include a statement acknowledging that submission acts as a binding electronic agreement.
Can I collect waivers for more than one animal at a time?
This template includes fields for multiple animals so clients with barns or multi-pet households can list all expected patients in a single submission.
Where are the submitted waivers stored?
All responses are automatically saved in a connected Google Sheets spreadsheet, giving you an instantly searchable archive of every client consent form.
Get this form in your Google Drive
Save a copy to your Google Drive with one click (uses 1 credit). Or build from a PDF or description in the app.