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1. Parties: Identification of the pet owner (client) and the veterinary practice, including full contact details
2. Background: Brief context explaining the purpose of the consent form and its importance
3. Definitions: Key terms used in the document including 'emergency treatment', 'reasonable attempts to contact', 'authorized agents'
4. Pet Information: Detailed information about the pet including species, breed, age, name, and any existing medical conditions
5. Scope of Consent: Specific treatments and procedures being authorized, including routine care and diagnostic tests
6. Emergency Authorization: Provisions for emergency medical treatment when immediate action is required
7. Financial Responsibility: Agreement to pay for all authorized treatments and maximum authorized amount
8. Contact Protocol: Process for attempting to contact the owner and alternative contacts before proceeding with treatment
9. Duration: Period for which the consent remains valid
10. Liability and Indemnification: Limitations of liability and indemnification provisions for the veterinary practice
11. Signatures: Space for signatures of owner, witness, and veterinary representative
1. Boarding Authorization: Additional consent for boarding services if required during treatment period
2. Special Medical Instructions: Specific instructions for pets with chronic conditions or special needs
3. Transportation Consent: Authorization for transport to specialist facilities if needed
4. Photography Consent: Permission to photograph pet for medical documentation or training purposes
5. Alternative Treatment Options: Owner's preferences for alternative treatments in specific scenarios
1. Schedule A - Fee Schedule: Detailed breakdown of standard treatment costs and emergency fees
2. Schedule B - Emergency Contacts: List of alternative contacts authorized to make decisions in owner's absence
3. Schedule C - Medical History: Summary of pet's relevant medical history and current medications
4. Appendix 1 - Treatment Preferences: Detailed owner preferences for specific medical situations
5. Appendix 2 - CPR Directives: Specific instructions regarding resuscitation efforts and end-of-life decisions
Authorized Agent
Emergency Treatment
Reasonable Attempts to Contact
Treatment
Routine Care
Emergency Care
Maximum Authorized Amount
Medical Necessity
Veterinary Practice
Attending Veterinarian
Pet
Critical Condition
Standard of Care
Diagnostic Tests
Stabilizing Treatment
Euthanasia
DNR (Do Not Resuscitate)
Contact Period
Business Hours
After Hours
Authorization Period
Boarding Services
Major Medical Procedure
Minor Medical Procedure
Treatment Plan
Professional Fees
Emergency Contact
Medical Records
Specialist Referral
Medical Consent
Emergency Treatment
Financial Responsibility
Liability
Indemnification
Contact Protocol
Duration and Termination
Confidentiality
Record Keeping
Payment Terms
Treatment Limitations
Communication Protocol
Standard of Care
Force Majeure
Dispute Resolution
Governing Law
Amendment
Severability
Entire Agreement
Veterinary Services
Animal Healthcare
Pet Care Services
Medical Services
Professional Services
Animal Boarding
Emergency Animal Care
Legal
Veterinary Operations
Client Services
Administration
Emergency Care
Compliance
Risk Management
Front Desk
Medical Records
Veterinarian
Veterinary Practice Manager
Veterinary Technician
Legal Counsel
Veterinary Clinic Administrator
Emergency Veterinary Coordinator
Client Services Manager
Risk Management Officer
Compliance Officer
Practice Owner
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