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Informed Consent Form

Thank you for considering our hospital as your pet’s provider of veterinary services. We are dedicated to maintaining the health of your pet and look forward to many future years together. So that we can have the most up to date information, please complete this form prior to your pet’s appointment. The required sections have a red * asterisk.
  • Owner Info

  • Pet Info

  • Cancellation Policy:
    In order to help all of our patients, we require a 24 HR cancellation notice. If you are more than 7 minutes late for your appointment, we will reschedule for another time. Please initial on the line below.*

    A. (Who can bring my pet in for treatment) Other than you and the co-owner, are there any other persons (18 years or older) to whom you give primary responsibility for the care of your pets? (Authorized agents are not automatically entitled to make medical treatment decisions for your pet, unless you give permission in section

    B). If yes, please list them in the order you wish us to contact them in the event that you or the co-owner is not available.
  • I certify that I am the primary owner listed above, I am at least eighteen (18) years of age, and this information is correct to the best of my knowledge. I further acknowledge that no guarantee has been made as to the results that may be obtained. I understand that complications may arise which cannot be predicted and that I will be held financially responsible for any veterinary medical care necessitated by complications. By typing my name below, I consent to the practice contacting me by e-mail and by text message for the purpose of health information and appointment reminders. I will ensure that I keep the practice informed of my up to date mobile number at all times, or if the number is no longer in my possession. PAYMENT IN FULL IS EXPECTED AT THE TIME OF SERVICE*
  • Release of Medical Records


Make an Appointment Book Now

Emergency

In case of an EMERGENCY after hours, you can contact us on our pager for a phone consultation. The number for the pager can be found at the bottom of one of your receipts, or on our magnet we sent home with you. If we are unavailable you can contact Lakeshore Veterinary Specialist in Oak Creek, WI at (414) 761-6333 or WVRC in Racine, WI at (866) 542-3241.

Airvet

Contact Us

9052 Prairie Ridge Blvd
Pleasant Prairie, Wisconsin
53158

Phone: 262-694-6515
Fax: 262-694-5046
For general inquires: Email Us
To submit records: Send Here

Hours of Operation

Monday: 8:30am – 7:00pm
Tuesday: 8:30am – 7:00pm
Wednesday: 8:30am – 7:00pm
Thursday: 8:30am – 7:00pm
Friday: 8:30am – 7:00pm
Saturday: 8:30am – 2:00pm
Sunday: 10:30am – 3:00pm

 

© 2021 Care Animal Hospital.
Powered by LifeLearn Veterinary Websites

  • About Us
    • Contact
    • Our Veterinarians
    • Our Staff
    • Employment
    • Testimonials
  • Clients
    • What to Expect
    • Request an Appointment
    • Request a Refill
    • Registration Form
    • Loyalty Program
    • Airvet App
    • PetPage App
  • Pet Record
    • Request an Appointment
    • Request a Refill
  • Services
    • Physical Medicine
    • Anesthesia and Patient Monitoring
    • Avian Medicine
    • Breeding Services
    • Exotic Pet Medicine and Surgery
    • Health Screening Tests
    • Medical Services
    • Preventive Services
    • Surgical Services
    • Wellness and Vaccination Programs
  • Pet Health
    • Pet Health Library
    • How-To Videos
    • Pet Health Checker
    • News
    • FDA Grain Free Diet Information
    • Rabbit Hemorrhagic Disease
  • Links
  • Payment Options