Hospitalization Consent Form – Heights Veterinary Clinic

Hospitilization Consent Form

Hospitalization typically involves keeping your pet in our clinic in order to administer intensive care such as intravenous fluids, injectable medications, monitoring pain control, post-operative care, hydrotherapy, vital monitoring, other similar treatments. Pets that are hospitalized are frequently seriously ill and are at risk of sudden deterioration of their condition.

In the event that my pet’s condition suddenly worsens, or cardiac or respiratory arrest occurs, I would like the staff at Heights Veterinary Clinic to:*
- Perform any and all emergency procedures necessary to stabilize my pet
- Contact me first before performing any emergency procedures
- DNR Do Not perform any heroic measures to stabilize my pet
Consent*
I agree
I understand that there will be additional charges for any emergency procedures performed.
Consent*
I agree
Heights Veterinary Clinic is not a 24 hour facility. For pets that are hospitalized at our clinic I understand that there will be times at night and during the weekend when your pet will be unattended.
Consent*
I agree
I certify that I am the owner of the above pet, and do hereby give my consent and authorize Heights Veterinary Clinic to perform any procedure or treatments that the doctor deems necessary for the health and safety of my pet while under their care and supervision.
Date*
Date Format: MM slash DD slash YYYY
Pet Owner Signature*
Emergency Phone Number*

Hospitilization Consent Form

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