Drop-Off Form

I am the owner/agent for the pet described above, and I authorize/request an examination for said pet. I understand that sedation and/or pain medication will be provided if deemed appropriate. In the event of examination for seizures, an intravenous catheter will be placed so that medication can be rapidly given if the patient has an active seizure while in the care of the clinic. I understand that while an initial basic estimate will be provided, more diagnostics may be needed, and Dr. Veronica Flores will notify me of any changes.

If I cannot be reached at the above phone number, I authorize initial diagnostics if indicated for my pet, including:

In the event my pet needs treatment and I am unable to be reached, I authorize initial treatment, including fluid support and other supportive medications, to be started as indicated for my pet. If my pet is presented for an abscess, laceration, or other wound, I authorize anesthesia, surgery, and medication as needed. If anesthesia/sedation is required, I understand that there are risks involved and that in the event of an emergency, the hospital will take all necessary actions to control the problem and will notify me as soon as possible. I understand and agree to the use of humane euthanasia in my animal when deemed appropriate by the veterinarian. I understand that if my pet is found to have fleas or ticks, I will be charged for flea/tick medication, and a dose will be applied in the office.

I fully understand that this is an estimate only. TWAH makes every effort to remain within the estimate given.

All accounts are payable at the time of pickup.