Estimate Consent Form

If your pet is coming in for a surgical procedure this form is required to be completed before we can operate.

Estimate Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 802-888-7776 for a faster response.

Updates on COVID-19 – Hospital Policies For All Appointments
*This form is required for all appointments with a doctor. Please fill this form out at your earliest convenience and at least 24 hours before your appointment.

I, being responsible for my pet, have the authority to grant you my consent to receive, prescribe for, treat, and/or operate upon my pet. I understand the surgical and/or dental procedure that my pet is being admitted for. You are to use all reasonable precautions against injury, escape, or death of my pet, but, you will not be held liable or responsible in any matter in connection therewith as it is thoroughly understood that I assume all risk. I assume full responsibility for the treatment expense involved. *

By checking here I agree to the above statement.

Name *

Procedure being performed *

Date procedure is being performed *

Owner's Name *

First

Last

By entering your name here you are signing and agreeing to the above statement in regards to your pets surgical and/ or dental procedure. You understand the risks and costs of said procedure.

Today's Date *

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Estimate Consent Form

Estimate Consent Form

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