Treatment Consent Form

Start

Consent Form

Complete the form below, and a member of our team will be in touch shortly if we have any questions. Please Note: Any fields with * are required.

I hereby authorize the following people to present my pet(s) for treatment in my absence should an injury or illness occur to my pet(s) that requires veterinary care. I will provide the following people with a payment method such as cash, check, or credit card (Visa, Mastercard, or American Express) to pay the bill at the time of service. *

Print Name

This authorization also includes any medical treatments, anesthesia consents, or surgical procedures needed (and any charges with fees incurred for the above). The total amount should not exceed ($):

I authorize any veterinarian to provide my pet with veterinary care and essential medical service. Do you authorize intensive medical efforts for your pet? *

In the event that the attending veterinarian determines that my pet is suffering and/or is incurably injured, do you consent to euthanasia? Please understand that if your pet's health is this critical, we will try everything in our power to get in contact with you before any decisions are made. *

I will be able to be reached at the following phone number: *

Pet Caretaker #1 *

First

Last

Phone *

Signature *

Pet Caretaker #2

First

Last

Phone

Signature *

Date *

Treatment Consent Form

Consent Form

Request An Appointment

306-518-4206

contact@cityparkvet.com

706 Duchess St #1, Saskatoon, SK S7K 0R3, Canada

Have a question?