• Patient Check-In Questionnaire

  • We look forward to seeing you and your pet on their upcoming visit. Please help us make this process a little easier by filling out this check-in questionnaire.  Due to COVID19 social distancing restricionts all of our appointments are done with curbside check-in.

    When you arrive for your appointment you have two options for check-in:

    Call (845) 354-1800 to check-in, notify the reception team that your pet has arrived for their appointment, and give your parking space number.

    Text COMING SOON with your pet's name and parking spot number to get checked-in.

    Once our reception staff have your pet checked in a technician will be out to bring your pet in to be seen.

    PLEASE REMAIN AT THE CLININC WHILE YOUR PET IS BEING SEEN. 

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  • Consent

    I, the undersigned owner or agent of the owner, hereby consent to the examination of my pet by Rockland Veterinary Care (RVC).  I agree that after consultation with me, the hospital's Doctors may prescribe medication for, treat, hospitalize, anesthetize and.or perform surgery on my pet.  I understand that no guarantee can be made as to the outcome of treatment and that I am encouraged to discuss any concerns I have about the risks of treatment with the attending Veterinarian before any procedures or treatment is initiated.

    I understand that a treatment plan including an estimate of the costs for Veterinary Services will be provided to me and that I am encouraged to discuss all fees related to such care before services are rendered and during my pet's ongoing medical treatment.


    I hereby authorize the name(s) above to make financial and medical decisions for the patient listed. I understand the professional fees are to be paid at the time services are rendered and a deposit is required on all pets admitted to the hospital.


    I understand that I (the owner or agent) am financially responsible to RVC for all charges relating to this patient.  I have read and agree to the treatment authorization.  I have also read and accept the financial obligations.

    Client Rights:

    As a valued client at Rockland Veterinary Care, you have the right to-

    • receive respectful and considerate care for your pet in a safe setting
      to be provided the name of the treating veterinarian and receive information about your pet's health status by the veterinarian managing your pet's care
    • to receive as much information about any proposed treatment or procedure as you need to make an informed medical decision
    • to participate actively in decisions regarding your pet's medical care
    • to establish an advance health care directive for your pet
    • to seek a second opinion with another veterinarian at RVC or another facility if pet is stable to be transferred
    • to refuse treatment and to be informed of the medical consequences of such refusal
    • to examine and receive an explanation of charges related to your pet's care
    • to designate authorized caretakers or persons who can make medical decisions in your absence
    • to receive free copies of your pet's medical records or to have those records forwarded to another veterinary provider.


    Client Responsibilities:

    Our medical team practices medicine in the best interest of the individual patient and cannot practice medicine based on requests or demands for particular medication, tests or treatments. We are committed to the future of veterinary professionals and as such, employ licensed DVM associate veterinarians. All staff at RVC have a right to be treated with respect in the workplace. RVC reserves the right to terminate a relationship with any Client who's abusive (including yelling, demeaning statements or threatening language towards Veterinarian, staff, other clients or vendors); who after making an informed decision disputes medical outcomes; who repeatedly misses appointments or repeatedly cancels same day; or who does not pay for services. 

     

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