General Consent for Care and Treatment Consent(Required) I AGREE TO THE TERMS AND CONDITIONS
TO THE CLIENT: At this point in your pet’s care, no specific treatment plan has been recommended. This consent form is simply intended to obtain your permission to perform the evaluation necessary to identify the appropriate treatment and/or procedure for any identified condition(s). I understand that the cost of examination will be charged once a nurse or staff member begins collecting information about your pet whether a doctor examines your pet or not. Once examined, you will be informed about the condition of your pet and any recommended surgical, medical or diagnostic procedures to be used so that you may make the decision whether or not your pet should undergo any suggested treatment or procedure. You should always ask about any risks and hazards involved in any recommended diagnostic, therapy, or procedure.
This consent provides Buffalo City Vet with your permission to perform reasonable and necessary medical examinations, testing and treatment. By signing below, you are indicating that (1) you are of legal age to enter into a contract in New York, (2) you intend that this consent is continuing in nature even after a specific diagnosis has been made and treatment recommended; and (3) you consent to treatment at this office or any other office under common ownership. The consent will remain fully effective until it is revoked in writing. You have the right at any time to discontinue services.
You have the right to discuss the treatment plan with your veterinarian about the purpose, potential risks and benefits of any test, therapy, or procedure ordered for your pet. If you have any concerns regarding any test or treatment recommended by your veterinarian, we encourage you to ask questions.
Buffalo City Vet strives to protect the information it collects. You understand that your signature releases Buffalo City Vet from all liabilities associated with theft of this information by any entity, including but not limited to all consequential damages. Requests for medical records may be made by other owners, veterinarians, insurance companies, or other entities. By signing this for you authorize Buffalo City Vet and its employees to release information they believe necessary for the continued care, therapy, and treatment of your pet. This may mean that your pet’s medical record is shared with 24-hour/ER facilities, specialty facilities, and other entities. Buffalo City Vet also reserves the right to use information collected about your pet for research and educational purposes. Unless required by law, medical records will NOT be released without proper authorization from you or your agent if requested from an outside entity not associated with your pets care. You may have to sign additional forms to authorize release of those records.
We encourage the use of pet insurance to help with the cost of the healthcare of your pets. We will digitally provide all records to any authorized entity associated with your account as requested. You acknowledge that Buffalo City Vet is NOT responsible for filing, completing, or verifying and paperwork associated with an insurance claim. Buffalo City Vet is not liable for the decisions, practices, or failure to perform of any insurance provider.
Buffalo City Vet does not house, board, or care for patients without owners present or overnight. Any pet left after close of the facility will be transferred to the local municipal animal control entity as an abandoned animal. You understand that failure to collect an animal does NOT waive the financial obligations accrued through the performance of diagnostics, treatment, hospitalization, and other care given.
You also acknowledge that payment is due at the time of service. Billing is NOT offered through Buffalo City Vet (or its subsidiaries) in any form. For hospitalized cases and cases requiring a procedure be performed, a deposit is required in advance. The balance is due upon discharge from the hospital. You may pay with cash or accepted credit cards, CareCredit, ScratchPay. We do not accept personal checks.