附錄 99.3

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委任表格 — 將於 2024 年 6 月 26 日舉行的年度股東和特別會議 702,央街 67 號 多倫多 ON M5E 1J8 委任代理持有人 我/我們是Cardiol Therapeutics Inc.的下列簽名持有人,特此任命大衞 Elsley 或者 Chris Waddick(“管理層被提名人”) 如果此人不是此處列出的管理候選人,則打印您要任命的人的姓名: 作為我/我們的代理持有人,擁有完全的替代權,可以出席、行動和投票並根據以下指示(如果沒有給出 的指示,則以代理持有人認為合適的方式代表持有人)和所有其他可能在Cardiol Therapeutics Inc.年度股東大會和特別會議之前適當提出的所有其他事項,該會議將在美國東部時間下午 4:30 或任何休會期間虛擬舉行 https://web.lumiagm.com/253136217 1。選舉董事。對於預扣換扣款 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.任命審計員。任命 BDO Canada LLP(特許專業會計師事務所)為公司的審計師,並授權董事會確定 薪酬。 用於預扣税 3.綜合激勵股權計劃決議。批准和批准公司綜合股權激勵計劃下的未分配獎勵。 針對反對 授權簽名 — 必須完成本部分才能執行您的指令 。 我/我們授權您按照我/我們的上述指示行事。我/我們 特此撤銷先前就會議提供的任何委託書。如果上面沒有提到 的投票指示,則將按照管理層的建議對該代理進行投票。 簽名:日期 MM/DD/YY 中期財務報表 — 如果您想通過郵件收到 中期財務報表及隨附的管理層討論 和分析,請選中右邊的複選框。有關注冊通過電子郵件發貨的説明,請參見反向鏈接。 年度財務報表 — 如果您想通過郵件收到 年度財務報表及隨附的管理層討論和分析 ,請勾選右邊的複選框。有關注冊通過電子郵件發貨的説明,請參見反向鏈接。

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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.