Holcomb Bridge Animal Hospital agrees to receive from the owner the animal(s) described on the front page of this form and give to it such medical, surgical, and dental treatment, as it may deem advisable.
The owner acknowledges the his/her animal(s) is under the care of his/her personal veterinarian or any other veterinarian designated by the owner’s personal veterinarian, and that the hospital shall not be liable for any acts or omissions in following the order(s) of said veterinarian(s). The owner hereby consents to any treatments or services rendered by the hospital pursuant to the order of said veterinarian(s). The owner’s personal veterinarian, or if said veterinarian is unavailable, any other veterinarian may be called in attendance by the hospital whenever deemed necessary or advisable by the hospital, and any and all expenses incurred thereby shall by the owner’s responsibility. If a veterinarian other then the owner’s personal veterinarian is called, as above, the owner acknowledges that the hospital is not liable for any acts or omissions in following the order(s) of the said veterinarian.
The owner understands that there is a risk involved in surgery and anesthesia and will not hold Holcomb Bridge Animal Hospital and its veterinarians responsible for any unforeseen complications.
The hospital shall not be responsible for theft, loss, or destruction of any personal property left with the animal(s) listed on the front of this form.
The owner hereby authorizes the hospital to release information from the animal’s records to any person, agency, or authority as the hospital, in its sole discretion may determine necessary.
The owner, or financially responsible person, agrees to pay upon discharge Holcomb Bridge Animal Hospital the charges specified for the care, keeping, and board of the animal described here with entrusted to its care. The owner or financially responsible person agrees to pay in full all the charges incurred during any periods where payments for such charges are pending determination of insurance companies.
The owner agrees to remove the animal(s) within 10 days after the request for removal is made. Should the animal(s) not be removed within specified time, the owner hereby relinquishes all claims to the animal(s) and Holcomb Bridge Animal Hospital is at liberty to dispose of the animal(s) as it may seem fit.
Accounts thirty (30) days delinquent shall bear a service charge at the maximum legal rate. Should the account be referred to an attorney for collection, the owner or financially responsible person agrees to pay attorney’s fees, collection costs, and other cost of litigation.
Holcomb Bridge Animal Hospital will notify the owner to any prior charges in quoted rates more than 15% (fifteen percent). This agreement will remain in effect until such time as a different agreement is reached.
Any paragraph that shall be deemed to be invalid shall not invalidate the remainder of the agreement.
If for any reason our personnel have provided to and/or from the hospital transportation, neither they nor the hospital is to be considered liable for loss or injury to your animal(s).Go back