Client Form

I consent to releasing my medical records to the above listed veterinarian.


I hereby authorize the attending veterinarian to examine, prescribe for, treat, and/or operate upon my pet. I assume all risks with regard to restraint, anesthesia, surgery, and general care of the above mentioned pet.

understand, and agree, that any estimate given for medical, surgical, and/or diagnostics procedures is not a definite cost quote. I assume all financial liabilities incurred for professional services rendered, and I understand that I will be required to prepay for all services. I further understand, and agree, that in the event that I do not prepay for such services, that the treating veterinarian shall have the right to discontinue treatment. If I walk away without paying in full, I may be prosecuted to the fullest extent of the law. All bad checks will be turned over to the District Attorney for collection.

I understand that if my pet stays in the hospital, I must pick up my pet by 7:00am on the morning of discharge from the clinic. Failure to do so will result in an extra $35.50 fee.

I have read and agree to the above.

CPR Choices

Due to the nature of emergency room visits, it is possible that your pet may stop breathing or suffer a cardiac arrest while under our care. Therefore, we need to be aware of your wishes in advance. This difficult decision is important and involves three medically standard choices. Please check which option you would like and sign at the bottom. Your doctor or technician will be happy to answer any questions.

I understand that I give the doctors permission to perform, or not perform, CPR on my pet according to my choice above. I also understand that I have the right to change my choice at any time or if my pet’s condition changes. Please notify the doctor of any changes to your wishes.