TREATMENT CONSENT:
By signing this form and submitting this document, I declare I am the lawful owner of all listed pets and all information is true and correct to the best of my knowledge. I hereby authorize the veterinarian(s) of The Center for Bird and Exotic Animal Medicine to examine, prescribe for or treat the my pet(s) to the best of their abilities. I assume responsibility for all charges incurred in the care of this animal. I acknowledge that medical information will not be released to anyone not indicated on this form without my express verbal and/or written permission with the exception of another veterinary facility.

EXTRA LABEL USE OF PHARMACEUTICALS: 
By signing this form and submitting this document, I acknowledge that Extra-Label Use of pharmaceuticals is acceptable therapy to be used in their pet or animal, as deemed necessary by the attending veterinarian and they have read and understand both our Billing and Pharmaceutical Use policies. All prescription drugs are regulated by the FDA and must be approved for specific use in humans and/or specific animals at specific doses. To be approved, each drug must go through a series of testing and analysis to understand not only the benefits and effects, but also the side-effects and risks of its use typically in dogs and cats and, in some medications, horses, cows, pigs and occasionally chickens, rats and rabbits. At this time, no drug or pharmaceutical is approved by the FDA for use in any pet bird, reptile or most small exotic mammals, and very few are approved in rats and rabbits. Use of pharmaceuticals in species for which they are not approved is allowed, however, and is termed “Extra-Label Use.”

MEDICATION REFILL POLICY:
By signing this form and submitting this document, I acknowledge that in order to request medication refills through CBEAM, I must securely store a credit or debit card on file. Requested medication refills will be charged for the price of the medications as soon as they are ready. If I do not pick up my medications within two weeks of being notified, my medications will be discarded. I will not be eligible for a refund if my medications are discarded due to not being picked up in the allotted time frame.

PAYMENT POLICY:
By signing this form and submitting this document, I acknowledge that payment is due at time of service. Acceptable forms of payment are cash, Visa, Mastercard, Discover, Care Credit and Scratch Pay.