Phone: (314) 822-2882 A member of the Barrett Station team should have provided what to select in the “Procedures to be Performed” section. If I cannot be reached by phone, I do not authorize any unforeseen dental procedures. Select the appropriate form for the kind of service your pet needs. The nature of the procedures has been explained to me and no guarantee has been made as to the results or cure. Pet Name. Telemedicine Consent Form Tamarack Veterinary Clinic and its Veterinarians and Technicians wish to consult with you regarding your pet’s medical status following an initial exam or procedure in clinic. Anesthesia/Surgery Consent Form. Customize the template with 123 Form Builder's coding-free interface. Male; Neutered Male; Female; Spayed Female; Sex. General: 315-946-4875. lyonsvet@yahoo.com . Hospitalization Consent Form " Fill out the hospitalization consent form online! I agree to waive any or all claims against Wellness Veterinary Clinic in the event of injury,complications, or death of my animal. Thursday:  8am – 8pm Wednesday:  8am – 8pm 3960 SW 109th Ave, Miami, FL 33165 . Friday: 7:30 am – 5:00 pm Grooming Consent Form. 2. Ormond Beach Veterinary Clinic 226 Vining Court Ormond Beach , FL 32176 (386) 677-0507 Anesthesia/Surgery Consent Form Client ID: Patient ID: Client Name: Name: Address: Species: Breed: Sex: Telephone: Color: Markings: Procedure: Birth Date: 303 W 1st Street. Name of Patient * Sex * Admit For * I certify that I own/have assumed financial responsibility for the above-described animal. If you have any questions on which form to select, please call the Kewaskum Veterinary Clinic at (262) 626-2380. Surgery and Anesthesia Consent Form. "By filling in the chart, the owner becomes actively involved and responsible for proper oral dosing," Dr. Short says. Another handy tool for demodectic mange management, this form outlines the protocol for home administration of oral ivermectin and lists possible side effects (a consent form is included to acknowledge off-label use of the treatment). Stillwater Veterinary Clinic is pleased to provide you with a Anesthesia consent form that can simplify the process of getting veterinary care for your pet. Tuesday:  8am – 6pm Dental Consent Form Download Form . Please fill in all the questions and bring with you at check-in. SPAY/NEUTER SURGERY CONSENT FORM WNER INFO Owner Name Date of Surgery Street Address City State Zip Cell Phone Home Phone Email INFO Name Species / Sex Age Primary / Secondary Color Breed Microchip Number Yes No Does your pet have any current medical conditions (including coughing, sneezing, vomiting or diarrhea)? Instructions for … Treatment Consent Form. © 2021 Barrett Station Veterinary Clinic. Initials *. Our doctors will be out of the office from 11:30 am to 1:30 pm for the lunch hours. Vidalia, GA 30474. If you have not yet scheduled an appointment, please contact us at (503) 477-4757. Online Forms; Appointments; Services; Contact ; General Consent Form. Feline Consent Form for Declaw. Wednesday: 7:30 am – 5:00 pm When you arrive for your first session you must bring with you a signed vet consent form. Address Line 2. Last. We provide loving care with a gentle touch and take every possible measure to give your cherished pets the treatment they deserve. Save the completed form as a new file and email it to the clinic as an attachment. City. K9 Massage Clinic works in accordance with the Veterinary Surgeons Act 1966 and Exemption Order 2015 and will never work on a dog without gaining veterinary approval prior to your first visit. Consent * I am over 18 years of age. Consent form and waiver: I hereby request that Wellness Veterinary Clinic provide the service for my animal. Along with caring for animals, we also offer numerous resources for pet owners, so they can take better care of their best friend. Veterinary Surgery Consent Form. You should use this Veterinary Surgical Consent Form Sample instead of creating a consent form manually. Monday 7:30am - 5:30pm. Don't make clients fill out complicated fillable PDFs or go through the hassle of printing paper forms. I have read and fully understand this form and declare I voluntarily provide my informed consent. *. Offer a streamlined and simplified process with digital forms instead. Cats; … Download the blank form to your computer. Saturday: Closed Friday:  8am – 5pm Home Care After Surgical Procedures. I will not hold Skyline Veterinary Clinic, the veterinarians, or any staff member … 3. Consent * I have read and understand this authorization and consent form and agree to pay services in full at the time my pet is discharged, unless previous arrangements have been made with the office manager. Zip Code. Thank you for choosing Wildwood Veterinary Clinic for your pet’s procedure. Forms – Valley Veterinary Clinic. Boarding Consent Form Menu. Surgical Consent Form. Telemedicine is the delivery of health care services using email, text messaging, interactive audio or video technology, where the patient and the veterinary professional are not in the same physical … Contact Us Lyons Veterinary Clinic. Phone * Address * Address Line 1. State. *. Dallas Veterinary Clinic - Treatment Consent Form. Email: [email protected], Monday: 7:30 am – 5:00 pm For general information, questions, appointment requests, call us at: (912) 537-1069 Fax: (912) 537-1113 Email Us: vidaliaveterinaryclinic@gmail.com. We are now able to accept new clients with Dr. Crowley and Dr. Dempsey! Phone: 509-926-4206 Day Admission Form Download Form. If yes, please describe: Is your pet taking any … Veterinary Surgical Consent Template has the pet information, owner details, surgery information, and authorization or consent that the medical staff requires the … Nurse Clinics; Exotic Pets; Hydrotherapy; Physiotherapy; Puppy Training; Repeat Prescriptions; Bereavement; Latest. I understand that Hales Corners Veterinary Clinic will do everything in their power to prevent these circumstances from occurring. furthermore, i understand that during the performance of the procedure(s) that i have authorized, unforeseen conditions may arise. Sunday:  CLOSED. Front Declaw and Spay or Neuter Form. Name * First. Press Enter. Date. Prior to your visit, please complete the form below to provide your consent to treat your pet. I hereby indemnify the veterinarians and staff of this clinic against any claims of whatsoever nature flowing from or related to the euthanasia of the pet described hereunder. If you have any questions or issues with the form, please call us at (503) 477-4757. This form will be used for any surgical procedure performed on a pet. Consent for Treatment or Surgery: I hereby authorize and direct the veterinarian of Pampered Pets Veterinary Clinic & Spa to perform the above described procedure (s). Dental Consent Form. Date * This field is required. Consent Forms. Our Latest News; Latest Offers; Pet Health. Location. Tuesday 7:30am - … Operation Satisfaction Form; GDPR Consent form; Client Feedback; REGISTER; Services. Tuesday: 7:30 am – 5:00 pm Acknowledgement and Consent of Surgical Risks As the owner, or agent of the owner of the animal above, I hereby give KKM Veterinary Clinic consent to perform surgery and/or treatments for my pet. Download Form. I authorize Walnut Creek Veterinary Clinic to perform any additional diagnostic, treatment, or surgical procedures deemed necessary for medical or surgical complications or otherwise unforeseen circumstances. For after-hours emergencies, please call: (912) 537-1069. 1961 Rt. Dental Consent Form. Age/Date of Birth. If you have any questions, please call us directly at 732-634-5242. Date of Appointment * By checking this box, I certify that I have read and understand the surgical information provided to me regarding my pet's surgery and the potential risks/complications that may be associated with surgery and anesthesia. The nature and purpose of the procedure (s) has been explained to me and I understand that no guarantee exists as to the result of diagnosis and treatment of the said animal. General Consent Form - (305) 553-0033. My initials on this consent form indicate that any questions have been answered to my satisfaction. i also do hereby acknowledge that i understand that there are no guarantees either expressed or implied that the … Chena Veterinary Clinic is a full-service animal hospital that welcomes both emergency and regular treatment cases. I have been made aware of the risks involved and release Hales Corners Veterinary Clinic from any legal and financial responsibilities arising from anesthetic complications. Lakeshore Emergency Preregistration. So that we may expedite your experience, please fill out the surgery and anesthesia consent form below prior to your visit. Press Enter. Saturday:  9am – 3pm We look forward to seeing you and your pet. Certified Veterinary Technicians – our CVTs are specially educated and trained to provide the best possible care; for your pet’s best health and safety, only CVTs or DVMs monitor anesthesia in our practice ; Inhalant Anesthesia – allows your pet to sleep and wake up faster, smoother, and safer Owner's Name * Account # * Phone * Emergency Phone * Pet's Name * Dog or Cat * Dog; Cat; Age * Sex * Breed * Color * Spayed / Neutered * Yes; No; I AUTHORIZE WESTWOOD VETERINARY CLINIC,TO PERFORM … Surgery Consent Form. I understand that during the performance of this procedure, © 2021 Valley Veterinary Clinic. SURGERY / ANESTHESIA CONSENT FORM. Help ease the stress and anxiety pet owners feel before surgery by simplifying how your clinic collects and manages data with our veterinary consent form. Boarding Consent Form We are currently not offering any boarding at this time. Dog Spay or Neuter Form. Previous Next Submit. Website design by Kettle Fire After submitting the information below, you will be taken to a completed consent form where you can electronically sign the consent or print and bring with you to your appointment. 1. therefore, i hereby consent to and authorize the performance of such procedures as are necessary in the exercise of the veterinarians professional judgment. Sunday: Closed. My initials on this consent form indicate that I fully understand these risks and understand that the veterinarians and hospital staff will try to minimize such risks. Pet Information * This field is required. Home; About; New Clients. New Client Form. Lion Shave Form. Thursday: 7:30 am – 5:00 pm Use this veterinary surgery consent form in your practice to inform pet owners about the details and risks of surgeries their pets need to undergo. Provided by ePet Websites | Powered by LifeLearn WebDVM. Hours. Anesthesia/Surgery Consent Form. Canine; Feline ; Species. I have read and understand. I prefer to be called before any additional procedures, other than emergencies. Please give us a call if you need services and are interested in coming to Walnut Creek! Download Form Bloodwork & Vaccine Consent Form. If I cannot be reached, I authorize you to proceed with all necessary dental procedures. Hospitalization Consent Form. If you are unsure, please call us at 314-822-2882 to ensure the correct procedure is selected. Complete the fillable PDF form using your computer’s PDF reader program. Previous Next Submit. ©2021 Pikes Peak Veterinary Clinic. If you have any further questions or concerns, a veterinarian or veterinary technician will be glad to address them with you. Prior to your visit, please complete the form below to provide your consent to treat your pet.  A member of the Barrett Station team should have provided what to select in the “Procedures to be Performed” section.  If you are unsure, please call us at 314-822-2882 to ensure the correct procedure is selected. It is easy! We share the same goal – ensuring your pet is healthy and happy. Vidalia Veterinary Clinic. Home Care for Dental. Cat Spay or Neuter Form. Fill out our Dental Consent Form before your visit to Walnut Creek Veterinary Clinic. All Rights Reserved. As the owner, or authorized agent of the above named animal, I hereby consent and authorize the clinic to receive, prescribe, treat, or operate on this animal. Our office will remain open for prescription and food pick ups. 14 Lyons, NY 14489. Fax: (314) 821-3979, Monday:  8am – 8pm
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