Talega AH - Authorization for Emergency Care

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Your pet is currently being evaluated for emergency care. This can include radiographs (x-rays), IV catheter and fluids, medications, oxygen, etc. The veterinarian will perform the care needed to stabilize your pet. The cost for this emergency care may be less than but could exceed $500. These costs will be incurred before you talk to a veterinarian about your pet's condition. By signing below, you are authorizing the veterinarian to perform this initial stabilization and are agreeing to pay the charges incurred. Payment must be rendered at the time services are performed unless prior arrangements are made with our Practice Manager.

The veterinarian will talk to you about your pet's problems, prognosis and the total cost of your pet's care after his/her initial treatment.
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Signature* This field is required.
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Date
Date
Year
Month
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Client's Printed Name
Email*
Pet's Name
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If you do not wish to consent to this initial care, please tell the receptionist immediately. The doctor will be out to talk to you before treating your pet. Failure to sign this form does not mean that we will not treat your pet; however, your pet's treatment will be put on hold until you have talked to the veterinarian and the delay could potentially worsen the outcome.
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