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Client Forms

Below are all our essential client forms that you can fill out here on our website. These include our new client form, rabies intake forms, and consent for treatment form.

Contact us if you have any questions!

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Forms In Addison County Vt
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For Your Convenience

New Client Form

New Client / Patient
Pet Owner Name
Pet Owner Name
First
Last
Address
Address
City
State/Province
Zip/Postal

Secondary Contact

Consent for Treatment

Consent for Treatment
Patient Name
Patient Name
First
Last
I am the owner or the authorized agent for the owner of the animal described above, and I have the authority to execute this consent. My signature below certifies that I am over eighteen years of age.

I have been informed that there are certain risks and complications associated with sedation,anesthesia, and/or any operation/procedure and that the risks/complications have been explained to me. I further understand that during the course of the operations or procedures, unforeseen conditions may arise that may necessitate the performance of additional procedures deemed necessary by the veterinarian. I am encouraged to discuss any concerns I have about these risks with the attending veterinarian before the procedure is initiated.

I authorize the use of appropriate anesthesia and pain relief medication as needed before, during or after the procedure. I have been informed that there are risks associated with the use of any medication.

The nature of these operations or procedures has been explained to me and I understand what will be done. I am aware that the practice of veterinary medicine is not an exact science and, thus, there are no guarantees for successful treatment. I have been encouraged and given the opportunity to discuss any questions I may have regarding my pet's medical care and my questions have been answered to my satisfaction. I accept that my financial obligations remain regardless of the outcome.

I have read and understand this authorization and hereby accept and agree to the terms of the consent for treatment.

Name
Name
First
Last
CPR
In the event that your pet should experience cardiac or respiratory arrest while being hospitalized today, do you give consent for resuscitative efforts to be initiated until you can be contacted further and notified of your pet's status?

By consenting to this service, you are also acknowledging that certain fees will apply. If you are not able to be contacted immediately, resuscitation efforts will be continued to be performed at the doctor's discretion. Please initial your choice below.

CPR and Resuscitation

Rabies Vaccination Clinic Intake Form

Rabies Intake Form
Client Information
Patient Name
Patient Name
First
Last
Would You Like to Receive Documents and Reminders Via Email:
Type
Would You Like to Receive Text Reminders

Patient Information

Pet's Name
Pet's Name
First
Last
Species
Mix
Microchip
Pet Symptoms Last 2wks (Check All That Apply)
plus1 Add an additional Patient minus1 Remove a Patient
Payment Information
Preferred Method of Payment
Receipt Method