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1. Parties: Identification of the pet owner (client) and the veterinary practice, including full contact details
2. Background: Brief context explaining the purpose of the form and its importance
3. Definitions: Key terms used in the document including 'emergency treatment', 'routine care', 'authorized representative', etc.
4. Pet Information: Detailed information about the pet including name, species, breed, age, and any existing medical conditions
5. Authorization Scope: Specific details about what treatments and procedures are being authorized in the owner's absence
6. Financial Authorization: Maximum approved spending limit and payment terms
7. Emergency Contact Details: Alternative contacts who can make decisions if the owner cannot be reached
8. Duration of Authorization: Period for which the consent remains valid
9. Communication Protocol: How and when the practice should attempt to contact the owner
10. Signatures: Space for owner's signature, date, and witness signatures
1. Special Medical Instructions: For pets with chronic conditions or specific medical needs requiring special attention
2. After-Hours Care Authorization: Specific provisions for emergency treatment outside normal business hours
3. Insurance Details: If the pet is insured, details of the policy and claim procedures
4. Euthanasia Authorization: Specific instructions regarding end-of-life decisions in emergency situations
5. Transportation Authorization: Permission to transport the pet to specialist facilities if needed
6. Boarding Requirements: If post-treatment boarding might be needed, specific instructions and authorization
1. Schedule A: Pet Medical History: Detailed medical history including vaccinations, previous conditions, and current medications
2. Schedule B: Authorized Treatments: Specific list of pre-approved routine treatments and procedures
3. Schedule C: Fee Schedule: Standard pricing for common procedures and treatments
4. Schedule D: Authorized Representatives: Detailed information and verification documents for any persons authorized to make decisions
Veterinary Services
Animal Healthcare
Pet Insurance
Professional Services
Animal Welfare
Legal
Compliance
Veterinary Operations
Administration
Client Services
Risk Management
Documentation
Front Desk
Clinical Operations
Quality Assurance
Veterinarian
Veterinary Nurse
Practice Manager
Veterinary Receptionist
Legal Counsel
Compliance Officer
Insurance Coordinator
Animal Welfare Officer
Clinical Director
Administrative Manager
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