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Consent for Virtual Appointment
Name
First
Last
Pet's Name
Name
Phone Number
I, hereby consent to participate in a virtual appointment with a licensed veterinarian from Smart Vet. I understand that this appointment will focus exclusively on the specific concerns I raised when booking the appointment, as part of a focused Veterinary Client-Patient Relationship (VCPR).
*
I understand and agree
This agreement does not establish a valid VCPR. A VCPR will not be established until the veterinarian has examined the patient and agreed to provide veterinary services.
*
I understand and agree
Focused Consultation: The appointment will be limited to discussing the specific issues I identified at the time of booking.
*
I understand and agree
Virtual Format: This appointment will be conducted via a virtual platform. I will be working with a Registered Veterinary Technician who in partnership with the veterinarian will be their hands-on to ensure my pet gets high quality care. I will ensure a suitable environment for the consultation.
*
I understand and agree
Limited Examination: I understand that the veterinarian will conduct a limited examination and that any additional concerns may require a separate in-person visit in which I may need to seek an alternative Veterinary Hospital.
*
I understand and agree
Privacy and Confidentiality: My personal information and my pet’s medical information will be kept confidential in accordance with applicable laws.
*
I understand and agree
Emergency Situations: If my pet requires immediate medical attention or emergency care, I may need to seek appropriate in-person veterinary services elsewhere.
*
I understand and agree
Consent to Treatment: I give my consent for the veterinarian to provide recommendations, medical advice, prescriptions, treatments, and prognoses related to the specific concerns discussed during the appointment.
*
I understand and agree
Here at Shannondale Pet hospital, we prioritize a compassionate and professional environment for both pets and their owners. We encourage clients to maintain respectful and courteous behavior during visits, as this fosters a positive atmosphere for all. Open communication is key—feel free to ask questions or express concerns about your pet’s care. Together, we can create a supportive space and high quality care for your beloved companions.
*
I understand and agree
Fees: I understand that I am responsible for any fees associated with the virtual appointment, as outlined by Shannondale Pet Hospital.
*
I understand and agree
New Clients:
Clients are scheduled with our virtual vet service. If you'd like to continue your pet's care with Shannondale Pet Hospital, please don't hesitate to contact one of our team members for more details.
Today's Date
*
Date Format: MM slash DD slash YYYY
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About Us
Join Our Team
Location & Hours
Meet Our Team
History of Shannondale Farm
What’s happening at Shannondale
Memorials
Forms
Links
Clients
Take A Tour
Pet Insurance
Survey Form
Request an Appointment
Services
Dental Healthcare
Euthanasia and Aftercare
How do I setup the appointment?
What happens during the appointment?
What actually happens when my pet is put to sleep?
Will the procedure be painful for my pet?
What are my options for aftercare?
I am having a difficult time grieving my loss. What support resources are there?
Anesthesia and Patient Monitoring
Medical Services
Preventive Services
Surgical Services
Wellness and Vaccination Programs
Additional Services
Emergency Information
Pet Health
Educational Articles
How-To Videos
Pet Health Checker
News
Pet Portal
Contact Us
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