There are some topics that are difficult for pet parents to talk about because they feel embarrassed or guilty. You can tell us anything about how you feel - we will not judge you. 

By signing this document, I hereby consent to the provision of veterinary telehealth services by Paws at Peace Veterinary Care PLLC.

I understand that veterinary telehealth involves the delivery of veterinary services using electronic communications, information technology, or other means between a veterinarian (or a veterinary technician operating under the
veterinarian's supervision) and a client who is physically located at a site different from the veterinarian
or veterinary technician. This may include, but is not limited to, consultation, diagnosis, treatment, transfer of medical data, and education.

I acknowledge that certain limitations exist in the delivery of veterinary telehealth services and that, in some cases, in-person evaluation and treatment may be necessary. I understand that the decision to provide services via telehealth is made at the professional discretion of the veterinarian, considering the circumstances of my pet's health condition.

I agree to the following terms and conditions:

1. I understand that the laws that protect privacy and the confidentiality of veterinary medical information apply to telehealth, and that no information obtained in the use of telehealth which identifies me will be disclosed to researchers or other entities without my consent.

2. I understand that I have the right to withhold or withdraw my consent to the use of telehealth in the course of my pet's care at any time, without affecting the right to future care or treatment.

3. I understand the potential risks to the use of technology, including interruptions, unauthorized access, and technical difficulties. I understand that either I or the veterinarian has the right to discontinue the telehealth consult/visit if it is felt that the videoconferencing connections are not adequate for the situation.

4. I understand that I will be responsible for any copayments or deductibles that apply to the telehealth service, just as I would for an in-person visit.

5. I understand that telehealth may involve electronic communication of my personal medical information to other medical practitioners who may be located in other areas, including out of state.

6. I consent to the use of telehealth by Paws at Peace Veterinary Care PLLC for the performance of the following veterinary services:

Quality of life teleconsultation

under the terms described herein.

This consent form is to be kept on file by the veterinary clinic/veterinarian and a copy provided to the client upon request.