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Dr. Frey Specialty Procedure Booking and Deposit
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Dr. Frey Specialty Procedure Booking and Deposit Consent Form
Owner's Name
(Required)
First
Last
Pet's Name
(Required)
Procedure(s) to be performed:
(Required)
Date of Procedure to be performed:
(Required)
Booking Deposit Acknowledgement
I hereby understand that upon scheduling I have paid a $300 deposit that is non refundable if canceled within 48 hours of scheduled appointment. If canceled within that window, the entire deposit will be forfeited. I understand this will be applied to the total bill on the day of my pets procedure. I understand my pet needs to be dropped off within the surgery window dictated by ABC Veterinary Hospital Staff.
(Required)
I agree and understand
I hereby understand that a mobile specialist will be traveling to ABC Veterinary Hospital Pacific Beach to perform the requested procedure (requested by me, the owner), the surgeon will not be one of the resident veterinarians at ABC Veterinary Hospital Pacific Beach. I understand I will not have the opportunity to meet this surgeon face-to-face prior to, or after my pet surgery, and agree for the resident veterinarians to manage my pets surgical care before and after the procedure.
(Required)
I agree and understand
By signing below, I agree that I understand and acknowledge all of the above.
(Required)
Your Name
Your Name
Your Name
Your Name
Date of Acknowledgment:
(Required)