I hereby authorize the doctors at Rhinebeck Equine to perform veterinary services on my horses. Payments are due when services are rendered. Interest of 1.5% per month will be charged on all overdue balances. I hereby consent to the personal jurisdiction of the City/Supreme Courts of Columbia County, New York, and agree that any dispute shall be venued in one of these courts. I further agree that in the event of breach, Rhinebeck Equine shall be entitled to recover the costs of collection, including reasonable attorney's fees. I am the owner of the described horse and have the authority to execute this consent. I hereby authorize Rhinebeck Equine, LLP to examine and if necessary, treat said horse according to the following term and conditions. Rhinebeck Equine, LLP and its officers, agents and employees will provide such veterinary medical care as they deem reasonable and appropriate under the circumstances.
Rhinebeck Equine, LLP and its officers, agents and employees will use reasonable care in the treatment of the above mention horse, but will not be liable for any loss or accident that may occur or any disease that may develop as a result of the care and treatment provided.
In executing this form, I hereby expressly acknowledge that risks, benefits and alternative forms of treatment have been explained to me, and thus I understand the explanation and consent to treatment. Should any additional treatments or diagnostics be required during the continued care of my horse, I understand that I will be given the opportunity to discuss and consent to these additional procedures. I understand that further or additional treatment may be required without an opportunity for discussion and consideration by me in the case of the development of any emergency during the continued care of my horse and I expressly consent to all such reasonable treatment as required. I realize and understand that results cannot be guaranteed.