Consent
I, the undersigned owner or agent of the owner, hereby consent to the examination of my pet by Dana Park Veterinary Hospital (DPVH). I agree that after consultation with me, the hospital'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 DPVH 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.
Client Rights:
As a valued client at Dana Park Veterinary Hospital, you have the following rights:
- to receive respectful and considerate care for your pet in a safe setting
- to be provided the name of the treating veterinarian and receive information about your pet's health status by the veterinarian managing your pet's care
- to receive as much information about any proposed treatment or procedure as you need to make an informed medical decision
- to participate actively in decisions regarding your pet's medical care
- to establish an advance health care directive for your pet
- to seek a second opinion with another veterinarian at DPVH or another facility if pet is stable to be transferred
- to refuse treatment and to be informed of the medical consequences of such refusal
- to examine and receive an explanation of charges related to your pet's care
- to designate authorized caretakers or persons who can make medical decisions in your absence
- to receive free copies of your pet's medical records or to have those records forwarded to another veterinary provider
- to speak with the Hospital Manager and file a grievance or complaint
- to terminate care at DPVH and to expect coordinated care with another veterinary clinic of your choice.
Client Responsibilities:
Our medical team practices medicine in the best interest of the individual patient and cannot practice medicine based on requests or demands for particular medication, tests or treatments. We are committed to the future of veterinary professionals and as such, employ licensed DVM associate veterinarians. All staff at DPVH have a right to be treated with respect in the workplace. DPVH reserves the right to terminate a relationship with any Client who's abusive (including yelling, demeaning statements or threatening language towards Veterinarian, staff, other clients or vendors); who after making an informed decision disputes medical outcomes; who repeatedly misses appointments or repeatedly cancels same day; or who does not pay for services. Under California law, you may not film or record any image, sounds or conversation with a DPVH employee or veterinarian without the consent of all parties to the conversation and violation of this law may result in criminal or civil liability.
For more information, please ask to speak to our Hospital Manager Deanna Hovinga directly or by email dhovinga@danaparkvethospital.com to further address an issue.