PAYMENT IS REQUIRED IN FULL AT THE TIME SERVICES ARE RENDERED. ACCEPTABLE FORMS OF PAYMENT ARE CASH, AMEX, VISA, MASTERCARD, DISCOVER, CARECREDIT, AND SCRATCHPAY (CHECKS WILL NOT BE ACCEPTED).
I, the undersigned owner or authorized agent, certify that I have the authority to execute this consent. I authorize the veterinarians and staff of West Hills Animal Hospital to perform the scheduled procedure and administer necessary sedatives or general anesthetics. I understand that:
1. Inherent Risks: Any anesthetic procedure involves inherent risks, even in apparently healthy animals.
2. Potential Complications: Rare but possible complications include allergic reactions, cardiac instability (arrhythmias/hypotension), respiratory depression, or acute death.
3. No Guarantees: Veterinary medicine is an inexact science; therefore, no warranty or guarantee of a successful outcome has been stated or implied.
I understand that I assume financial responsibility for all services rendered, and that payment is due upon hospital discharge of my pet.
To provide the highest standard of care for your pet, we require a deposit equal to the low end of your provided estimate at the time of admission.
Remaining Balance: If the final cost exceeds the deposit, the remaining balance is due in full at the time of discharge.
Credits: If the final cost is less than the deposit, any resulting credit will be issued back to you during the discharge process.