附录 99.3

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委任表格 — 将于 2024 年 6 月 26 日举行的年度股东和特别会议 702,央街 67 号 多伦多 ON M5E 1J8 委任代理持有人 我/我们是Cardiol Therapeutics Inc.的下列签名持有人,特此任命大卫 Elsley 或者 Chris Waddick(“管理层被提名人”) 如果此人不是此处列出的管理候选人,则打印您要任命的人的姓名: 作为我/我们的代理持有人,拥有完全的替代权,可以出席、行动和投票并根据以下指示(如果没有给出 的指示,则以代理持有人认为合适的方式代表持有人)和所有其他可能在Cardiol Therapeutics Inc.年度股东大会和特别会议之前适当提出的所有其他事项,该会议将在美国东部时间下午 4:30 或任何休会期间虚拟举行 https://web.lumiagm.com/253136217 1。选举董事。对于预扣换扣款 a. David Elsley b. Jennifer Chao c. Michael Willner d. Colin Stott e. Peter Pekos f. Guillermo Torre-Amione 博士 g. Chris Waddick h. Teri Loxam 2.任命审计员。任命 BDO Canada LLP(特许专业会计师事务所)为公司的审计师,并授权董事会确定 薪酬。 用于预扣税 3.综合激励股权计划决议。批准和批准公司综合股权激励计划下的未分配奖励。 针对反对 授权签名 — 必须完成本部分才能执行您的指令 。 我/我们授权您按照我/我们的上述指示行事。我/我们 特此撤销先前就会议提供的任何委托书。如果上面没有提到 的投票指示,则将按照管理层的建议对该代理进行投票。 签名:日期 MM/DD/YY 中期财务报表 — 如果您想通过邮件收到 中期财务报表及随附的管理层讨论 和分析,请选中右边的复选框。有关注册通过电子邮件发货的说明,请参见反向链接。 年度财务报表 — 如果您想通过邮件收到 年度财务报表及随附的管理层讨论和分析 ,请勾选右边的复选框。有关注册通过电子邮件发货的说明,请参见反向链接。

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INSTEAD OF MAILING THIS PROXY, YOU MAY SUBMIT YOUR PROXY USING SECURE ONLINE VOTING AVAILABLE ANYTIME: This form of proxy is solicited by and on behalf of Management. Proxies must be received by 4:30 pm, Eastern Time, on June 24, 2024. Notes to Proxy 1. Each holder has the right to appoint a person, who need not be a holder, to attend and represent them at the Meeting. If you wish to appoint a person other than the persons whose names are printed herein, please insert the name of your chosen proxyholder in the space provided on the reverse. 2. If the securities are registered in the name of more than one holder (for example, joint ownership, trustees, executors, etc.) then all of the registered owners must sign this proxy in the space provided on the reverse. If you are voting on behalf of a corporation or another individual, you may be required to provide documentation evidencing your power to sign this proxy with signing capacity stated. 3. This proxy should be signed in the exact manner as the name appears on the proxy. 4. If this proxy is not dated, it will be deemed to bear the date on which it is mailed by Management to the holder. 5. The securities represented by this proxy will be voted as directed by the holder; however, if such a direction is not made in respect of any matter, this proxy will be voted as recommended by Management. 6. The securities represented by this proxy will be voted or withheld from voting, in accordance with the instructions of the holder, on any ballot that may be called for and, if the holder has specified a choice with respect to any matter to be acted on, the securities will be voted accordingly. 7. This proxy confers discretionary authority in respect of amendments to matters identified in the Notice of Meeting or other matters that may properly come before the meeting. 8. This proxy should be read in conjunction with the accompanying documentation provided by Management. To Vote Your Proxy Online please visit: https://vote.odysseytrust.com You will require the CONTROL NUMBER printed with your address to the right. You can attend the meeting virtually by visiting https://web.lumiagm.com and entering the meeting ID 253-136-217. For further information on the virtual AGM and how to attend it, please view the management information circular of the company. The Meeting Password will be: "CARDIOL2024" case sensitive. If you vote by Internet, do not mail this proxy. To request the receipt of future documents via email and/or to sign up for Securityholder Online services, you may contact Odyssey Trust Company at https://odysseytrust.com/ca-en/help/. Voting by mail may be the only method for securities held in the name of a corporation or securities being voted on behalf of another individual. A return envelope has been enclosed for voting by mail.