Authorization to provide care:
1.I am the owner (or authorized agent of the owner). I hereby authorize and direct Midland Animal Clinic and Hospital, its veterinarians, technicians, and assistants to perform services, procedures, diagnostics, vaccinations, treatments, and/or administration of extra label medications as deemed necessary or advisable in connection with or relating to the matters described in the attached estimate or the matters that have otherwise been explained by Midland Animal Clinic and Hospital veterinarians or other Midland Animal Clinic associates.
2. I understand that there is a risk of complications with every procedure, including the possibility of death as a severe complication of surgery, anesthesia, or other procedures. I also understand that there is no guarantee as to the results of any procedures, diagnostics, vaccinations, or treatments. I understand that I may ask any questions regarding any procedure, diagnostic, vaccination, or treatment recommended by the Midland Animal Clinic and Hospital Veterinarian before it is performed.
3. I understand that there may not be a veterinarian at the hospital at all times. I understand that veterinary technicians or assistants may perform certain functions in the preparation and care of my pet even when a veterinarian is not present. I also understand that no staff will be present overnight. Unless the veterinarian advises that my pet may remain unattended in the hospital overnight. I will need to take my pet or transfer my pet to a hospital offering overnight care at the end of the day. If I fail to pick up my pet before the Hospital closes for the day, Midland Animal Clinic and Hospital may transfer my pet to a hospital offering overnight care if the veterinarian determines my pet cannot be left overnight care.
4. I agree that hospital staff may walk my pet outside. IO understand that in the event of an emergency, it may be necessary for my pet to be taken to an emergency hospital. I authorize Midland Animal Clinic and Hospital and its veterinarians and other personnel to transport my pet to an emergency hospital and to obtain treatment by the emergency hospital to stabilize my pet if I cannot be reached. Midland Animal Clinic and Hospital and its personnel may disclose such information and records regarding my pet to the other hospital as they consider necessary.
5. I understand that payment is due, in full at the time of services are rendered. I understand it is my responsibility to call the hospital daily, to be updated on my pet, and the costs incurred for medical services during that day. If I do not call or I cannot be reached, I understand it is my responsibility to pay what is due.
I understand that Midland Animal Clinic and Hospital does not request or require personal information as a condition to payment by credit card, but card users may be required to provide proof of identity. If for any reason payment is not made at the time services are rendered or within 10 days thereafter, I understand that my account may be referred to a collection agency. In the event that my account is referred to a collection agency, I agree that Midland Animal Clinic and Hospital may add an amount to my outstanding account balance to reimburse Midland Animal Clinic and Hospital for the reasonable collection charge (but not including attorney’s fees) imposed by the collection agency.
6. If I neglect to pick up my pet within 7 days, Midland Animal Clinic and Hospital may assume that my pet has been abandoned and is authorized to make such arrangements as it may deem best.
7. I understand and agree that portions of my visit or care and treatment of my pet may be recorded for educational purposes.
8. Should an unexpected life-threatening emergency take place:
