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I request that Petsadena Animal Hospital doctors and team perform the services which are necessary to the
examination and medical treatment of the animal(s) presented by me. I am the owner or agent for the owner of
the described animal(s) and have authority to execute this consent. Provider is hereinafter understood to mean
Petsadena Animal Hospital, its veterinarians, agents, and employees.
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I authorize the veterinarians on duty (and assistants they may designate) to examine the animal(s) and to
administer medical treatment or emergency care which is considered therapeutically and/or diagnostically
necessary on the basis of the examination findings. I, therefore, hereby consent to and authorize the
performance of such procedures as deemed necessary and desirable in the veterinarian’s professional
judgment.
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I understand that the treatment of the patient(s) will be conducted with due care and in accordance with the
prevailing standards of care in veterinary medicine. I certify that no guarantee or assurance has been made as
to the results that may be obtained through the course of treatment undertaken by the Provider.
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Accounts over 30 days past due shall pay interest at the maximum legal rate. I agree to pay all attorney fees,
interest, collection costs and other costs of litigation incurred in the collection of past due accounts.
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The Provider shall not be responsible for the loss, theft or destruction of any personal property left with my
pet(s).
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I understand that a treatment plan may be provided at my request. I also consent to the release of medical
information to other authorized veterinary and/or boarding facilities.
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I assume financial responsibility for all charges incurred to the patient for services rendered and understand that
full payment is required upon discharge.
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I permit and authorize Petsadena Animal Hospital and it's employees, agents, and personnel who are acting on
behalf of the Hospital to use my pet's photograph and first name for purposes related to the business of the
Hospital, including publicity, marketing, and promotion of the Hospital & it's various websites, including social
media.
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I authorize any person with possession of the described animal(s) in addition to myself to request
veterinary care for the described animal(s) and have the authorization to make medical decisions for the
described animal(s) in my absence. In addition, I understand all services/products rendered by that
person will be my financial responsibility.
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