• Patient Drop-Off Questionnaire

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  • Contact Information

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  • Treatment Consent

  • Consent

    I, the undersigned owner or agent of the owner, hereby consent to the examination of my pet by Lyndhurst Animal Clinic (LAC).  I agree that after consultation with me, the clinic'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 LAC 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.

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