Cambridge Client Center

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Cambridge Veterinary Hospital to release patient information to the primary care hospital or veterinarian.

By submitting this form, I hereby authorize Cambridge Veterinary Hospital to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of the patient from Cambridge Veterinary Hospital.

I am the owner (or authorized agent for the owner) of the above named animal and have the authority to execute this consent. I hereby authorize the above procedures by the clinic veterinarians and staff which may include diagnostic, therapeutic, surgical or preventative procedures and to administer sedation and/or anesthesia as deemed necessary. Further, I understand why such procedures are necessary, their advantages, and possible complications. No guarantee of successful treatment is made or implied.

I, the undersigned owner/authorized agent of the above listed patient, hereby authorized Badger Veterinary Hospital Cambridge and its staff to administer veterinary care to my animal. I understand that an estimate of the fees for veterinary services can be provided to me prior to service and that I am encouraged to discuss all fees related to such care before services are rendered. I agree to assume financial responsibility for the care provided here. All patients are discharged at the end of each business day; I realize that I am responsible for arranging pick up of my pet prior to the end of the business day. If emergency treatment is required and I cannot be reached, I authorize that life preserving action be taken for my pet until I can be contacted. I agree to assume full and complete financial responsibility for the balance of ALL services rendered (we accept cash, Visa, MC, Amex, and Discover) at the time my pet is discharged.

Like you, our greatest concern is the well-being of your pet. There are always potential risks when undergoing anesthesia and/or surgery. To reduce risks and better ensure your pets safety under anesthesia, we recommend a blood profile and ECG reading be preformed prior. Abnormalities may not be detected unless these pre-anesthetic tests are completed. These tests are similar to those your physician would run on you.

Pre-anesthetic bloodwork gives the doctor more information regarding your pets organ function, alerting us to the presence of infection, anemia, dehydration, diabetes, kidney or liver disease. Our advanced, in- house equipment enables us to perform the pre-anesthetic blood profile the morning of your pets procedure.

Bloodwork completed in the last 60 days won't be repeated unless the doctor deems necessary. *Because of increased anesthetic risk, pre-anesthetic bloodwork is
REQUIRED for all patients 8 years and older*

The pre-anesthetic ECG can identify heart structure abnormalities and irregular rhythms.
Our ECG readings are electronically submitted to a cardiologist with results available within 30 minutes.

We will complete a mandatory therapeutic cold laser treatment following your pets surgery to provide accelerated healing and greater pain management. Therapeutic cold laser is NOT performed on the following surgeries: ocular, mass, lump or tumor removals.

I am the owner (or authorized agent for the owner) of the above named animal and have the authority to execute this consent. I hereby authorize the above procedures by the clinic veterinarians and staff which may include diagnostic, therapeutic, surgical or preventative procedures and to administer sedation and/or anesthesia as deemed necessary. Further, I understand why such procedures are necessary, their advantages, and possible complications. No guarantee of successful treatment is made or implied.

Who may we contact, other than yourself, in case of an emergency with your pet?

All services MUST be paid for in full at the time of service, with NO EXCEPTIONS. This shall include routine health examinations, vaccinations, routine laboratory tests, surgeries, emergencies, prescription and non-prescription medicines, food and supplies. Payment may be made with Cash, Visa, MC, Discover, American Express and Care Credit. If payments are not received and the account becomes delinquent, the account will be subject to collections and/or legal action to enforce collection of money owed. If this becomes necessary, all expenses incurred in the collection of the debt including court costs and attorney's fee shall become the responsibility of the debtor in default. A service charge of $35.00 will apply in addition to the above, for any uncollected or returned checks.