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Patient Admission And Consent Form

Patient Admission and Consent Form

A document signed by a pet owner allowing a vet to treat their pet; without the signed consent form, some treatments may not be performed.

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Personal Information

Email*

Pet Owner's Full Name*

Pet Owner's Phone Number*

Pet Owner's Email Address

Pet's Name*

Pet's Breed*

Pet's Age*

Pet's Weight*

Pet's Gender*

10.

Pet's Medical History

Description:Ensure your pet's treatment is not delayed with our patient admission and consent form. This document allows you to give consent for your pet's treatment and ensures that all necessary treatments can be performed.

Make sure your pet receives the necessary treatment with our patient admission and consent form. This form is a legal document that allows you to give consent for your pet's treatment and ensures that all necessary treatments can be performed. Without a signed consent form, some treatments may not be able to be performed, which could delay your pet's recovery. Our form is easy to use and provides peace of mind knowing that your pet's health is in good hands.

Full Name*

Phone Number*

Address*

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Full Name*

Phone Number*

Address*

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Full Name*

Address*

Phone Number*

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First Name*

Last Name*

Phone Number*

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Full Name*

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Date*

Select date

Health Status*

I have not experienced any symptoms of COVID-19 in the past 14 days.

I have not been in close contact with anyone who has tested positive for COVID-19 in the past 14 days.

I have not traveled outside of the country in the past 14 days.

Agreement*

I understand and acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by visiting the salon.

I agree to comply with all salon policies and procedures to reduce the spread of COVID-19.

I release and hold harmless the salon and its employees from any and all claims, demands, and causes of action arising out of or relating to any exposure to or infection by COVID-19.

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