Rehab Drop Off

I am the undersigned owner of, or agent of the owner, responsible for seeking veterinary care for the above patient.  I consent to the treatment of this pet by the staff and veterinarians at Red Lion Veterinary Hospital LLC.  I agree that after consultation with me the hospital’s doctors may prescribe medications for, treat, hospitalize and/or sedate my pet if needed.  I understand that some risks always exist with anesthesia and am encouraged to discuss any concerns with the attending veterinarian before the procedure is initiated.  Should any lifesaving emergency care be required and the attending veterinarian is unable to reach me the hospital staff has my permission to provide such treatment and I agree to pay for such treatment.

I understand that an estimate of fees or services can be provided to me and that I am encouraged to discuss all fees related to such care before services are rendered.  I agree to assume financial responsibility for the fees accrued and will provide payment via cash, credit card or check at the time my pet is discharged from the hospital.  I further agree that I, or an authorized agent of mine, will pick up and pay for all accrued charges at the agreed upon time of discharge.

I understand that my pet may be muzzled or restrained if deemed necessary for the safety of the staff and my pet. *

I understand that my pet may be muzzled or restrained if deemed necessary for the safety of the staff and my pet.

I understand that this visit is for a rehabilitation service only as discussed previously with the rehabilitation therapist. Any additional procedures including vaccines, bloodwork, x-rays or full physical exams that I request preformed will be an additional charge. Furthermore, I will be required to have payment for all services rendered at the time of discharge. *

I understand that this visit is for a rehabilitation service only as discussed previously with the rehabilitation therapist. Any additional procedures including vaccines, bloodwork, x-rays or full physical exams that I request preformed will be an additional charge. Furthermore, I will be required to have payment for all services rendered at the time of discharge.

I understand that my pet must be up to date on vaccines and yearly physical exams in order to undergo rehabilitation therapy. This is for the safety and wellbeing of not only my pet but other pets in the hospital and the hospital staff. *

I understand that my pet must be up to date on vaccines and yearly physical exams in order to undergo rehabilitation therapy. This is for the safety and wellbeing of not only my pet but other pets in the hospital and the hospital staff.

Please list medications that your pet is on and the time these medications were last administered:

Was your pet sore or painful after the last session or anytime during the week after your exercise sessions? (If yes, please elaborate)

Do you have any new concerns or issues that you would like the Dr. or staff to be aware of?

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