Veterinarian Name *

Clinic Name *

Clinic Phone *

Clinic Email *

Client Name *

First

Last

Client Email *

Client Phone *

Pet's Name *

I, the above listed veterinarian, am authorizing Morgan Sain, CCFT to guide the above referenced dog and owner in strength, balance, and body awareness training. *

I have read and understand.

I understand that Morgan Sain, CCFT is a Certified Canine Fitness Trainer and she designs strength and balance programs for healthy dogs. I understand that she cannot diagnose or treat injuries. However, I acknowledge that she may assist in strength building after a surgery ONLY if I, the pet’s veterinarian, authorize the pet is healthy enough to do so. *

I have read and understand.

I understand that it is the dog owner’s responsibility to advocate for their dog during strength, balance, and flexibility training and that this training is at their own risk. If the dog shows any signs of weakness, injury, or pain during this training, Morgan Sain, CCFT will stop immediately and urge the owner to seek veterinary advice. *

I have read and understand.

I understand that this style of training, with or without inflatable balance products, is a trial process and each dog may respond differently to each exercise. All exercise plans could result in injury if performed incorrectly and/or without proper form. I am trusting Morgan Sain, CCFT to guide my patient in a way that best serves to avoid injury. *

I have read and understand.

I, the above listed veterinarian, have found the above listed pet healthy enough to participate in a muscle strengthening/conditioning program at West Chester Pet Resort with trainer Morgan Sain, CCFT. This pet has no physical restrictions at this time. *

I have read and understand.

I, the above listed veterinarian, have found the above listed pet is NOT healthy enough to participate in a muscle strengthening/conditioning program at West Chester Pet Resort with trainer Morgan Sain, CCFT. Please do not proceed with the fitness program at this time. *

I have read and understand.

I, the above listed veterinarian, have found the above listed pet is healthy enough to participate in a muscle strengthening/conditioning program at West Chester Pet Resort with trainer Morgan Sain, CCFT. However, this pet DOES have physical restrictions to be aware of during the training program. *

I have read and understand.

Please list physical restrictions or precautions (if applicable):

I would like copies of session/progress notes for your records:

Yes
No

I would like to APPROVE exercise plans before continuing:

Yes
No

Please note that by selecting yes to this question, Morgan will design a program for your patient but they will NOT be able to start it until we receive confirmation from your office.

If you, the veterinarian, are recommending/prescribing this training to your client, please also send additional information stating what muscle groups, motion types, body areas, etc. that this training should target. *

I have read and understand.

DVM Signature: *

Today's Date *

Veterinary Release Form for Canine Fitness Training