Please Note: We will be closed on Wednesday, December 25th and Thursday, December 26th in observance of Christmas!

Drop-Off Consent Form

Save time during your next appointment. Complete your drop-off consent form online from any device at any time before your visit.
A German Shepherd dog wearing a gray inflatable collar

Drop-Off Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

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Thank you for trusting your pet with us today! The following is important information to allow us to treat your pet at today’s visit.

Has your pet ever had a reaction to a medication or vaccine?
Is your pet taking any medications?
(if left blank, we will call if fee is over $250)
more than the current treatment plan range.

AUTHORIZATION TO PROVIDE CARE

I am the owner (or authorized agent) of the pet listed on this form. I hereby authorize Antelope Veterinary Clinic, its veterinarians, technicians and staff (Hereby referred to as Antelope Veterinary Clinic) to perform services, diagnostics, treatments, vaccinations and other treatments as deemed necessary by the veterinarian. I understand that Antelope Veterinary Clinic can give no guarantee as to the results of care provided and that there are always some risks associated with any procedure, including the possibility of death as a severe complication of anesthesia, surgery or other procedure.

I understand that Antelope Veterinary Clinic is not staffed after hours and should my pet require an overnight stay, 24-hour care will not be provided.

I understand that drop-off care is contingent on me being accessible by phone. If attempts have been made to reach me for consent to treat and I have not been accessible, standard care will be provided at the discretion of the vet and I will be financially responsible.

I accept full financial responsibility for the care provided to my pet today and understand that payment is due at the time of service. No credit or billing is allowed.

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