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Hospitalization typically involves keeping an ill pet in our clinic in order to administerintensive care such as intravenous (I.V.) fluids, injectable medications, paincontrol, post-operative care, vital signs monitoring, oxygen therapy, or othersimilar treatments. Pets that are hospitalized are frequently seriously ill andare at risk of sudden deterioration of their condition.

In the event that my pet’s condition suddenly worsens, or cardiac or respiratory arrest occurs, I would like the staff at Lakeside Animal Clinic to:

Perform any and all emergency procedures necessary to stabilize my pet
Contact me first before performing any emergency procedures
DNR Do Not perform any heroic measures to stabilize

There will be additional charges for any emergency procedures performed.

I accept.

Lakeside Animal Clinic is not a 24 hour facility. For pets that are hospitalized, there will be times at night and on weekends when your pet will be left unattended. You have the option of transferring your 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 accept.

In order to hospitalize your pet, Lakeside Animal Clinic requires a deposit in the amount of the estimate provided. If your total bill exceeds the estimate, then the balance will be due at the time your pet is discharged. If the total bill is less than the deposit, we will refund the overpayment at the time your pet is discharged, using the same payment method that was used to pay the deposit. Alternatively, a credit can be left on your account for future use.

I accept.

Lakeside Animal Clinic is not a 24-hour facility. For pets that are hospitalized, there will be times at night and on weekends when your pet will be left unattended. You have the option of transferring your 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. By Clicking below you are acknowledging that you understand our facility is not staffed between the hours of 6pm and 7am, Monday- Friday. We are open from 8am-noon on Saturdays, and we are CLOSED on Sundays. Adjustments for holiday hours will be posted. You are also acknowledging that the facility is not equipped with a fire protection sprinkler system in the event of a fire.

I accept.

Date

Pet Owner's Name

Email Address

Emergency Phone Number