Drop Off Questionnaire & Consent Form

Please provide the following information so we can be certain that we understand your pets’ needs, it is very important for you to be as specific as possible. If we need additional information, we can reach you at the number you give us today. Thank you.

There is a place at the bottom of the form for you to add any additional infomation.  If your responses do not fit into the spaces provided, please add the answer to the additional information section.  

Some pets require sedation for adequate physical exam and/or treatments.

After examination by the doctor, may we proceed with tests and/or treatments. 

If your animal is displaying signs of having fleas/ ticks/ worms and is found to be carrying them, we will AUTOMATICALLY treat the animal at a cost to the client. Thank you for understanding.

 

 

Consent for Treatment and/or Admission

I, the undersigned owner/agent of veterinarians at Thurman Veterinary Center. I also agree that after a consultation with me, the hospital’s doctor(s) may, consent to the examination of this pet by staff.

prescribe medication, treat, hospitalize, sedate, anesthetize and/or perform surgery on my pet. I understand that some risks exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about those risks with the veterinarian before beginning the procedure. Should unexpected life-saving emergency care be required and the veterinarian or staff member is unable to reach me, the hospital staff has my permission to provide such treatment, and I agree to pay all fees incurred. I understand that an estimate of fees for all veterinary services can be provided to me and that I am encouraged to discuss all fees related to the care before services are rendered and during my pet’s ongoing medical treatment. I understand that payment is due at the time of discharge. In some cases a deposit may be required.