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1. Pet and Owner Information: Details of the pet (species, breed, age, conditions) and owner contact information
2. Scope of Consent: Specific treatments and procedures being authorized, including routine care and preventative treatments
3. Duration of Consent: Time period for which the consent remains valid and conditions for renewal or termination
4. Financial Authorization: Maximum authorized spending, payment terms, and billing procedures
5. Emergency Procedures: Authorization for emergency treatments and procedures, including decision-making protocol
1. Alternative Contact: Secondary decision-maker details and authority levels for cases of extended absence or multiple decision-makers
2. Treatment Limitations: Specific exclusions or limitations on treatments, procedures, or medications
3. End-of-Life Decisions: Authorization and guidelines for euthanasia decisions in cases of terminal illness or severe suffering
1. Schedule A - Treatment Price List: Comprehensive list of standard pricing for common procedures and treatments
2. Schedule B - Medical History: Detailed summary of pet's relevant medical history, existing conditions, and current medications
3. Schedule C - Emergency Contact List: Prioritized list of emergency contacts with their respective decision-making authorities and contact details
Owner
Pet
Treatment
Emergency Treatment
Authorized Procedures
Financial Limit
Consent Period
Alternative Contact
Emergency Contact
Treatment Hours
Out-of-Hours Care
Euthanasia
Medical History
Pre-existing Conditions
Standard Treatment
Extraordinary Treatment
Practice Hours
Payment Terms
Authorized Representative
Treatment Location
Contact Attempts
Professional Fees
Medical Records
Financial Authority
Emergency Procedures
Communication Protocol
Duration and Termination
Treatment Limitations
Data Protection
Liability
Payment Terms
Record Keeping
Confidentiality
Dispute Resolution
Force Majeure
Insurance
Treatment Location
Quality of Care
Medical Decision-Making
Euthanasia Authorization
Alternative Contacts
Governing Law
Indemnification
Amendment and Modification
Severability
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