Form Builder

filter comments

Pet Name

If my pet requires further treatment during anesthesia or recovery, including emergency treatment, I authorize Lakeside Animal Clinic and its doctors to:

Proceed with treatment without contact
Attempt to contact first, and if you cannot reach me, proceed with treatment
Do not proceed with treatment without contacting me first

If client fails to make payment or pick up pet after 30 days, then the pet will be considered abandoned and become property of Lakeside Animal Clinic.

I accept.

Notes

All with fleas will be administered a Capstar for $8.00. Long-term flea control should be purchased at checkout.

All pets that are spayed and neutered will have a small tattoo applied to their abdominal skin. For safety reasons, all pets with long nails will have them trimmed while unrder anesthesia at no-charge to you.

I UNDERSTAND THAT LAKESIDE ANIMAL CLINIC IS NOT A 24 HOUR FACILITY. FOR PETS THAT ARE BOARDED OR HOSPITALIZED, THERE WILL BE TIMES AT NIGHT AND ON WEEKENDS WHEN MY PET WILL BE LEFT UNATTENDED. I UNDERSTAND THAT I HAVE THE OPTION OF TRANSFERRING MY PET TO A 24 HOUR CARE FACILITY OR EMERGENCY CLINIC AT CLOSING TIME. IN THE EVENT OF A FIRE, NATURAL DISASTER OR OTHER EMERGENCY, IT MAY BE IMPOSSIBLE TO GAIN ACCESS TO THE BUILDING. EVERY EFFORT WILL BE MADE TO KEEP PETS SAFE AND OUT OF DANGER.

I have read the information provided and understand there is an inherent risk associated with general anesthesia. Although Lakeside Animal Clinic attempts to minimize these risks, I understand that complications do occur. By signing below, I am declaring that I understand these risks and will not hold Lakeside Animal Clinic liable. I hereby consent to my pet being put under general anesthesia at the discretion of the doctors at Lakeside Animal Clinic. ABSOLUTELY NO PRE- OR AFTER-HOURS

At Lakeside Animal Clinic we treat our patients and their owners like family. We strive to provide the very finest in animal care. Our dedicated staff works diligently to address all your pet needs and your concerns and treat you with the utmost kindness and respect. We ask for the same kindness and understanding from you in return. Lakeside Animal Clinic has a zero-tolerance policy for abusive and/or offensive language or discourteous behavior towards our staff and doctors. By signing below, you agree to act appropriately towards our staff and understand that if you violate this policy you will be asked to seek veterinary care at another clinic that can better suit your needs.

Date

Owner's Name

Email Address

Daytime/ Emergency Phone

By completing this form, I certify this information to be correct to the best of my ability and I agree to the above-mentioned terms and conditions.

I accept.