• Online Store
  • 4437 Main Street, Gasport NY 14067
  • Online Store

New Client Consent Form

New Client Consent Form

Owner Contact Information


Pet Information


MUST BRING RABIES CERTIFICATE

NY law requires proof of Rabies vaccine.
Without proof of vaccine, it is the discretion of the veterinarian to revaccinate.

Authorization

I hereby authorize the veterinarian to examine, prescribe for or treat the above-described pet. I assume responsibility for charges incurred in the care of this animal. I understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I understand there will be a $50 fee for any returned checks. I also understand there is a non-refundable $75 deposit for a missed first appointment and a $65 fee for other no-show appointments.

 

Cancellation Policy

You must call 24 hours in advance if an appointment needs to be canceled or rescheduled to avoid a cancelation fee. A fee will be charged up to the amount of the service scheduled for any canceled appointments without notification. $28 for missed Tech appointment, $65 for missed Doctor appointment, $150 for missed Surgery appointment.

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