I acknowledge the following:
My veterinarian has offered me the option of a Telemedicine Consult in order to minimize risks to myself and the wider community of the current Covid-19 pandemic. This consultation may take the form of a phone call, facetime call or video conference via platforms such as Google Hangouts, Zoom or other, and will result in my veterinarian making a clinical assessment of my pet from a different location to myself.
I am undertaking this consultation with the understanding that there are limitations to what my veterinarian can deduce about my animal’s condition without a physical examination and/or other detailed investigations best done in the clinic. To minimize the risks of errors of clinical judgement my veterinarian may recommend that may require an in person exam pet at the clinic and/or undergo further diagnostic tests. This will then be up to me to decide if I proceed.
I understand that it is my responsibility to contact my veterinarian and/or bring the pet for an exam at the clinic (or nearest emergency hospital) if my pet’s condition persists or deteriorates unexpectedly.
I understand that payment for my consultation and any medications recommended, agreed to and/or delivered to me will completed in full on my nominated credit card at the end of this consultation. I have read the schedule of fees below and acknowledge that other charges recommended to me will need to be authorized in subsequent emails after I receive them from my vet in writing.
I understand that the cost of my Telemedicine consultation does NOT include payment for other services, examples of which include but are not limited to such things as drugs, medications, tests, surgery, procedures, diagnostics, referrals to specialists, hospital care, etc. If other services are recommended by my vet I understand that they will provide me with a written treatment plan listing these things and their costs.
I understand that I am consulting with one of the two veterinary professionals employed at Hancock Park Veterinary Clinic who are all registered Veterinary Practitioners in the state of California. I also confirm that my details including my stated residence in the state of California are correct.
I agree to RELEASE OF INFORMATION from Hancock Park Veterinary Clinic to any other health care facility or provider to which my pet’s care may be transferred.