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Treatment Consent

Name: Fairgrounds Animal Hospital
Address: 2435 Sutro St, Reno, NV, 89512, United States
Telephone: 775-329-4106
Price range: $

Please fill out this form as completely and accurately as possible.

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Treatment Consent Form

If you have any questions, please feel free to contact us at 775-329-4106.

Consent for Treatment

I hereby authorize the following people to present my pet(s) for treatment in my absence should an injury or illness occur to my pet(s) that requires veterinary care. I will provide the following people with a method of payment (Cash, Check, or Credit Card (Visa, Mastercard, Discover) to pay the bill at the time of service.(Required)

Print Name

This includes any medical treatments, anesthesia consents, or surgical procedures, and to sign for charges; with fees: not to exceed $

I authorize any veterinarian to provide my pet with veterinary care and essential medical service. Do you authorize intensive medical efforts for your pet?(Required)

Yes

In the event the attending veterinarian determines that my pet is suffering and/or is incurably injured, do you give your consent for euthanasia? Please understand that if your pet’s health is this critical, we will try everything in our power to get in contact with you before any decisions are made.(Required)

Yes

I will be able to be reached at the following phone number:(Required)

Pet Caretaker #1(Required)

First Last

Phone(Required)

Email(Required)

Pet Caretaker #2

First Last

Phone

Date(Required)

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Treatment Consent

Treatment Consent Form

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