I have discussed the reasons for hospitalization and I am satisfied with the plan of management. The nature of such services has been described to me to my satisfaction and I realize that neither guarantee nor warranty can ethically or professionally be made regarding the results or cure. I authorize use of sedatives and pain medications if deemed warranted. If anesthesia or sedation is required, I understand, and accept that there are always inherent risks, including death. I also authorize the clinic staff in an emergency situation, to follow through with such procedures as are necessary for the well being of my pet on a continuing basis until further communication with me is possible.

for anticipated medical services. It is understood that there may be unforeseen complications and that further treatment may be necessary during the hospitalization. I accept and assume full and total financial responsibility for any and all services rendered by the clinic, its staff or employees in the treatment of the above described animal and agree to pay the fees at the time of my pet’s discharge or other demise.

Please ensure that your designated agent is aware that you have given us his/her name, and is willing and able to make decisions regarding the care and well-being of your cat.

Any cat not claimed within ten (10) days of pick-up date, without new provisions being made, will be considered abandoned, and becomes our property and will be handled according to our best judgment.

Unless otherwise instructed your cat will receive Hill’s Science Diet. If your cat has other dietary needs, please provide the food or allow us to provide it at current charges.

The undersigned hereby warrants that they are the owner or authorized agent for the cat listed in this record and does consent and authorize our staff to care for and treat said cat. If an emergency situation arises, I authorize services, including the use of anesthesia if necessary, to treat my cat until such time as I can be contacted. I understand that every reasonable effort will be made to contact me as soon as possible if an emergency or unanticipated situation arises with my cat. If I am unable to be reached, I authorize the veterinarians to proceed with treatment as deemed necessary for the well being of my cat. I understand I will be responsible for all charges incurred at checkout.

If I have requested that medical, surgical, dental, or other services be performed for my cat while it is residing in the boarding kennel, I consent to and authorize our staff to perform diagnostic, therapeutic, anesthetic, emergency, and surgical procedures as are necessary and advisable for the treatment and maintenance of my cat’s health and well-being. I understand that with any procedure or treatment that there are risks that may not be predictable, including death, and I accept these risks. While I expect all procedures to be performed to the best of the abilities of the staff, I acknowledge that no guarantee or warranty regarding the outcome or results of any treatment has been given. I acknowledge that hair may be shaved or clipped as necessary to facilitate treatment. I expect that reasonable precautions will be used to ensure my cat’s safety and well-being while in our care, and I agree to pay in full for all services provided at the time of discharge. I understand that if an unanticipated need for additional procedures or services (e.g. extractions of teeth, biopsies of abnormal tissues, etc.) occurs, a reasonable effort will be made to contact me using the contact information provided above. I understand that if I cannot be contacted, that non-emergency procedures or services will not be performed, at that this may mean that my cat may need to have another procedure at a future date at my expense.

Treatment Authorization And Information

I hereby authorize Evergreen Animal Hospital to perform medical and diagnostic/ surgical procedures on my pet as required for diagnosis and treatment. I understand that I can terminate at any time by contacting the doctors or technicians.

How did you find us?

Financial Policy

We offer Care Credit, an outside lending service, if payment can't be made at time of service. Ask if needed

Payment Is Due In Full As Services Are Rendered

For emergency service, a deposit is required in advance based on the treatment plan. Payment may be made by cash, personal check (with proper identification current in state Drivers License) or accepted credit cards. In order to avoid misunderstandings, please let us know if these terms are not satisfactory

In the rare event payment is not made at the time of service. It is our policy to apply a service charge to the account balances over 30 days old. A billing fee of $2.00 and 1.5% of the outstanding balance will be charged to your account monthly if not paid in full. If applicable you will be responsible for any legal and/or collection agency expenses that may be incurred.

Returned checks are subject to penalties under the Colorado Returned Check Law, C.R.S 13-21-109, for additional information on the Colorado Returned Check Law See www.ago.state.co.us/CADC/BadCheckLaw.cfm or call the office of the Attorney General at 303-886-5304.

I understand that I, as the owner or agent, am financially responsible for the applicable Evergreen Animal Hospital charges relating to the treatment my pet(s). I have read and agree to the treatment authorization. I have also read and accept the financial policy.

Pet Emergencies When The Owner Isn't Available For Direction

Medical Boarding

Emergency contact information

Treatment Authorization & Information

How did you find us?

Financial Policy

We offer Care Credit, an outside lending service, if payment can't be made at time of service. Ask if needed

Payment Is Due In Full As Services Are Rendered.

Pet Emergencies When The Owner Isn't Available For Direction