Additional Information

• Unless you notify the veterinarian handling your case that you do not give permission, a copy of your pet's medical record will be available to your regular veterinarian.

• Payment is due at the time services are rendered. We will gladly prepare a written estimate before diagnostics and treatment are performed and after the doctor evaluates your pet. A deposit is required when a patient is hospitalized.

I hereby grant permission to the veterinarians in charge of the care of the pet described above to administer any treatment or anesthetics and to perform any such operations as may be deemed necessary or advisable in the diagnosis and medical care of this pet. I certify that I have read and understand the above information. I certify that I am at least 18 years of age and accept full responsibility for payment.

Critical Care Authorization

If your pet has been presented in a critical or life threatening state (i.e. - respiratory distress, active seizures, not breathing/no heartbeat, unconscious, etc.), we will need to assess and stabilize your pet. In order to initiate and/or continue acute care, we will need authorization of an initial estimate of at least $700, due at time of service, to perform immediate critical care procedures. This estimate is only for initial stabilization and does not include continued care such as hospitalization, treatments, medications or follow-up care. The doctors and staff will keep you informed as best as possible while performing life-saving procedures. We will provide you with a written estimate of expected charges for continued care at that time. A deposit will be required for patients remaining in the hospital for continued care.

Your signature below indicates that you have read and fully understand the above and are authorizing our doctors and staff to perform critical care stabilization.