New Client Registration
Please complete the online form below, which will be automatically received and processed by our reception team prior to your appointment.
Alternatively, you may download the PDF version and email it to admin@eldoraigneanimalclinic.com
Please contact us to book your appointment.
P: +27 (0) 12 492 9865 | M: +27 (0) 66 229 7124
TERMS AND CONDITIONS
CLAUSE 1: CONSENT
- I confirm that I am at least 18 years of age.
- I confirm that the veterinarian has explained the relevant treatment options, associated risks, prognosis, and the potential consequences of not proceeding with the proposed treatment.
- I confirm that I have had the opportunity to ask questions and raise concerns regarding the patient’s (animal’s) condition, the proposed treatment, and any associated risks, and that these have been addressed to my satisfaction.
- I understand and accept that no guarantees have been given regarding the outcome of the procedure, surgery, or course of treatment.
- I confirm that the option of euthanasia has been discussed, and I have chosen to decline this option in favor of the proposed treatment.
- I irrevocably consent to the veterinarian and clinic staff performing the necessary treatment on the patient (animal), including surgery, fluid therapy, anesthesia, and any other measures deemed necessary during the course of treatment.
- In the event that I cannot be contacted, I consent to the veterinarian exercising their discretion in administering any treatment they deem necessary to protect the patient’s (animal’s) health or to prevent further suffering.
- Based on the above, I request that the proposed treatment be performed on the patient (animal).
* The above will be discussed by the veterinarian after the consultation
CLAUSE 2: ACKNOWLEDGEMENT
- I acknowledge that all surgical or medical treatments carry inherent risks and complications, which have been explained to me, and I indemnify the veterinarian, staff, and clinic from any claims arising out of the treatment, except in cases of gross negligence or intentional misconduct.
- I acknowledge that the cost of treatment has been discussed with me, and I accept full responsibility for any and all charges incurred during the treatment of the patient (animal). * Discussed during the consultation
- I confirm that I am the owner of the patient (animal) or have been authorized by the owner to admit the patient (animal) for treatment and to provide instructions regarding their care.
- I acknowledge that the information I have provided about the patient’s (animal’s) health is accurate and complete.
- I acknowledge that the clinic is bound by the Animal Protection Act No. 71 of 1962 and is required to report any offenses under Section 2 of the Act to the relevant authorities.
- I acknowledge that if I do not collect the patient (animal) within the specified time, the clinic may, after 10 days, transfer the patient (animal) to a shelter, and I will be responsible for any additional boarding costs.
- I accept full financial responsibility for all costs incurred during the hospitalization and treatment of the patient (animal), payable upon collection. I also accept liability for any legal costs, including attorney fees, should the account not be settled as agreed.
- I acknowledge that the account is payable upon presentation/discharge and is subject to the National Credit Act.
CLAUSE 3: INDEMNITY
- The clinic and its representatives will take all reasonable precautions and act in accordance with their professional training to prevent injury, escape, or demise of the patient (animal). However, I understand that I assume all risks associated with the care, treatment, and safekeeping of the patient (animal), and I will not hold the clinic liable for any such outcomes, except in cases of gross negligence or intentional misconduct.
- I hereby indemnify the clinic against any actions, suits, proceedings, claims, demands, costs, and expenses of any nature that may arise from the treatment of the patient (animal), except in the event of gross negligence or intentional acts.
ACKNOWLEDGEMENT OF COST VARIABILITY
- The signatory acknowledges that the cost of treatment is an estimate and that the final cost may vary due to complications or other factors. The signatory agrees to be liable for the full amount as indicated on the final billing statement.
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