Drop Off Consent Form

Lots of love will be given to your pet during their stay with us! This form authorizes your pet’s hospitalization and delivery of your approved care for your pet. Please fill this form out completely and accurately.
* Indicates required information
Primary Contact Name(Required)
If you've had recent exposure or clinical signs associated with COVID-19, please be responsible and send someone else to drop-off and pick-up your pet or reschedule for a later date. This is extremely important for the safety of our staff and other clients. We greatly appreciate your honesty and empathy. We agree with your pet, you're the best.
Any of the items below a current problem?(Required)
Itchiness
Vomiting
Diarrhea
Coughing
Sneezing
Limping/Stiffness
Please list any and all prescription medications your pet is currently receiving (including dosage and when last given). Please click the green plus sign to add another medication. We know this can be a pain, but honestly it can be really important for us to know. If your pet is currently not receiving any prescription meds, please type "none".(Required)
Medication
Hour
Minute
AM/PM
 
Your pet will be monitored and cared for by and under the direct supervision of a veterinarian. Your pet will also be thoroughly and regularly monitored. We will contact you with updates or in the event of an emergency. Feel free to call at any point for an update on your pet and we will happily answer any questions you may have.
I hereby consent to and authorize treatment for my pet as deemed medically appropriate in the veterinarian’s professional judgement. I accept financial responsibility for any charges incurred during my pet’s care at your facility, including any emergency care and associated charges. I understand payment is due at the time of my pet’s discharge from the hospital and will render payment in full. Financing is available through ScratchPay during times of financial constraint.
Please only click "Submit" once and do not leave this page! This may take a few seconds. From everyone at PAZ - Thank You!
This field is for validation purposes and should be left unchanged.