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I, the undersigned, certify that I am the owner, or authorized agent for the owner, of the animal listed above. You, as the owner, have opted to have your pet admitted to the hospital for evaluation of an illness or drop off appointment. As this is an optional service provided by Strong Veterinary Hospital, I understand that the evaluation of my pet will be worked into the schedule as the veterinarian or hospital personnel see fit and that there is no guaranteed time when your pet will be evaluated. By admitting your pet to the hospital, you are agreeing to be financially responsible for at least the cost of an examination while your pet is here.
Once your pet has been evaluated, the examining veterinarian will contact you at the number listed above to discuss an estimate for diagnostics and/or treatments. Because we value your time, please CHOOSE ONE OPTION BELOW regarding how you would like us to proceed with diagnostics and/or treatments:
Flea control is particularly important for your hospitalized pet and our hospital. Should we discover that your pet has fleas or evidence of fleas, they will be treated according to their weight. In this manner, we can ensure the transmission of parasites is prevented between animals and we maintain a flea-free hospital environment. If we must treat your pet for fleas, there will be an additional cost added on to the invoice for that treatment.
If you decide to leave personal items at the hospital while your pet is undergoing a procedure (i.e. leash, collar, harness, etc), Strong Veterinary Hospital will not be responsible for any lost items.
I have read and understand this form and accept responsibility for payment of all charges incurred and services provided to my animal by Strong Veterinary Hospital.
29212 Five Mile Road,Livonia, MI 48154
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