1. I hereby authorize Monticello Animal Hospital to use their virtual care platform (text, video, email, social media, telephone, apps) for telecommunication which includes evaluating, educating and (tentatively) diagnosing my pet's medical condition.
2. I understand that technical difficulties may occur before or during the telehealth sessions and my appointment cannot be started or ended as intended.
3. I understand that a full physical exam may not be conducted on my pet using this online platform, and that an in-person exam may be recommended. I understand that if further in hospital care, or emergency care is warranted at MAH, care can be given at 22026 west 66th Street, Shawnee, KS.
4. I understand I am responsible for any fee that is accrued during the telemedicine consult with MAH.
5. I agree that my pet's medical records on telehealth can be kept for further evaluation, analysis and documentation, and in all of these, my pet's information will be kept private. I understand that I have the right to withhold or withdraw my consent to the use of telemedicine in the course of my pet's care at any time. I understand that my pet's medical information will be kept in a safe and secure manner and not shared with third party entities without my consent.