Client Responsibility Form

    Client Responsibility and Release for House Call Appointments:

    Our mobile practice allows for a decreased stress level for the pets and decreased time commitment for the clients. If patients must be chased, caught, dragged, or extracted, the potential for human and animal injury rises and the stress level is very high. This is also a waste of client and veterinarian time.

    It is the responsibility of the pet owner to confine or restrain their pets prior​to our arrival. Cats must be in a carrier or closed in a bathroom or small room with no furniture to hide under. Dogs must be on a leash and not loose in the yard or house. Housecall fee will be assessed if the following occurs:

    • The patient cannot be obtained within 15 minutes of arrival
    • All services are refused after we arrive for the appointment
    • No one is home for the scheduled appointment

    We appreciate our clients who already understand and abide by these requirements. Please read and sign below acknowledging your understanding and acceptance of these requirements.

    Your Name (required)

    Your Name (required)

    I understand that animals can be unpredictable; therefore, I assume full responsibility for any damage done by any of my pets to my family or my property. I further agree to cooperate with MLVS team members with whatever restraints we deem necessary as part of the examination or treatment of my pet(s). This includes services authorized by co­owner or other persons present for the appointment. I understand that any procedure carries some risk and that it is not possible to guarantee the successful outcome of any such procedure. This agreement will remain in force indefinitely from this date unless I notify MLVS in writing requesting to cancel the agreement.

    Deposits will be collected by credit card over the phone for all anesthesia procedures. This deposit is taken at the time the appointment is scheduled. Deposits will also be collected for any appointment involving 3 or more pets in the same household being seen at the same time.

    Date

    IN CASE OF EMERGENCY, CALL:

    Veterinary Specialty Hospital
    North Raleigh 919-861-0109
    Cary 919-233-4911
    Quail Corners 919-876-0739
    NCSU Vet Hospital 919-513-6500

    LOCATION HOURS

    Monday – Thursday 9:00am – 5:00pm
    Friday 9:00am – 2:00pm
    Saturday & Sunday Closed

    Patients are seen by house-call appointment only. Please call or email to schedule.