Client and Pet Registration Form

Client Information

Pet Information

Referring Veterinarian/Primary Veterinarian

Medical History

Tufts Veterinary Emergency Treatment & Specialties Agreement and Consent

• I understand that the cost of the initial exam does not cover any further diagnostic, treatment, or medication that may be necessary for my pet.
• I understand that payment is required at the time of the service and I agree to pay for all services rendered.
• I understand that in the event that further diagnostics or treatments are recommended by the doctor I may request an estimate of those charges first if I have not been provided one.
• I understand that I have the right to refuse any treatment, diagnostic, or medication that has been recommended to me by my doctor, and that medications are not returnable.
• I understand that Tufts VETS is not responsible for personal items such as leashes, collars, bedding, toys, etc. that are left with my pet, and that they may not be returned.
• I understand that Massachusetts law requires that Tufts VETS verify proof of current rabies vaccination for all dogs and cats presented to their hospital, and that if I do not provide a current rabies certificate for my pet, it may result in Tufts VETS vaccinating my pet prior to discharge at my expense.
• I understand that some doctors and staff utilize a voice capture program to aid in medical record documentation. I consent to this recording and understand that neither these recordings nor my voice will be used for any other purpose.
• I consent to the use of images of my pet, including photos, videos or diagnostic images, by Tufts VETS for purposes including but not limited to teaching, research, social media posts, hospital literature or signage, without additional approval by me.
• I understand that any abusive or disrespectful behavior towards Tufts VETS employees may result in dismissal from Tufts VETS care. Examples of dismissible behavior are included on the Tufts VETS website at https://tuftsvets.org/pet_owners/tufts-vets-hospital-policies.php.

Authorization of Medical Care

• I verify I am the owner, or authorized agent, of the above-named pet, and as such I am authorized to make medical decisions for their care.
• I understand that through the process of evaluation and treatment, my pet may require sedation, a minimally invasive procedure or it may be necessary to provide unanticipated medical or surgical intervention for the immediate safety of my pet. I understand that these interventions carry inherent risks that I hereby accept.
• I understand that whenever possible the managing veterinarian will contact me regarding emergent changes in my pet’s status and their recommendations, prior to intervention when possible.
• I understand that I will be counseled on the nature of, and possible risks for, interventions and that I must be responsible for asking questions to make informed decisions for my pet.
• I accept responsibility for additional charges that may be incurred for emergent interventions to my pet for its health and safety.

You and your doctor will be provided with a report from the doctor for every examination performed on your pet at Tufts VETS. Thank you for trusting us with your pet!