Hagersville Veterinary Services New Client Registration Form

Previous Veterinary Clinic

Please provide your previous clinic’s name and contact information. We will request your pet’s records and contact you to schedule an appointment once they are received.

AGREEMENT INFORMATION

The information provided in this agreement will help Hagersville Veterinary Services better serve the needs of my animal(s) and me. This agreement is between me, my animal’s co-owner(s) and/or authorized agent(s), and Hagersville Veterinary Services.

EXPECTATIONS OF HAGERSVILLE VETERINARY SERVICES

Veterinary services are provided by Hagersville Veterinary Services to paying clients. Hagersville Veterinary Services cannot professionally or ethically guarantee the outcome of any services provided. Hagersville Veterinary Services operates in accordance with the Veterinarian’s Oath and follows the standards and procedures set out by the College of Veterinarians of Ontario (CVO). The clinic maintains professionally trained staff and a high standard of patient care.

A veterinarian–client–patient relationship (VCPR) is required to access clinical veterinary services. A VCPR must be established before a veterinarian may recommend or provide any veterinary services, including prescribing, dispensing, or administering medications for any pet(s). An active VCPR is established at your pet’s first examination with the veterinarian. Annual examinations are required to maintain an active VCPR.

EXPECTATIONS OF CLIENT

I/we will submit all information about my/our animal(s) truthfully and willingly to Hagersville Veterinary Services and its staff. I/we understand the financial agreement, no-show policy, standard media release, and the behaviour expected while seeking services at Hagersville Veterinary Services.

FINANCIAL AGREEMENT

• I/we agree to pay for all services rendered at the time they are provided, without exception.
• Hagersville Veterinary Services will not store my/our payment information, including credit or debit card numbers.
• Hagersville Veterinary Services does not accept cheques as a form of payment.

NO SHOW & LATE CANCELLATION POLICY

Due to increased demand and longer wait times for veterinary services across the province, it has become more challenging for our clients to schedule timely visits. We have also seen a rise in the number of clients who fail to attend scheduled appointments despite reminders. Therefore:

• A $35 fee will be applied to my/our account if I/we fail to arrive for a scheduled appointment. This fee must be paid in full before a new appointment can be scheduled.
• A $35 fee will be applied to my/our account if I/we provide less than 24 hours’ notice for the cancellation of a scheduled appointment. This fee must be paid in full before a new appointment can be scheduled.
• A $150 fee will be applied to my/our account if I/we cancel a surgical procedure with less than 48 hours’ notice. This fee must be paid in full before a new surgical time can be scheduled.

STANDARD MEDIA RELEASE

• I/we give permission to Hagersville Veterinary Services to photograph and/or record my/our animal(s).
• I/we agree that Hagersville Veterinary Services may post images and/or recordings of my/our animal(s) on the Hagersville Veterinary Services website or Facebook page.
• I/we agree that Hagersville Veterinary Services may use these images and recordings for marketing and/or educational purposes.

BEHAVIOR EXPECTATIONS

At Hagersville Veterinary Services, our mission is to provide exceptional patient care and compassionate client communication. Delivering a high level of care and service requires mutual respect, cooperation, and kindness. To foster an inclusive and mentally healthy environment for both clients and staff, we have established a code of conduct for all Hagersville Veterinary Services clients. We respectfully ask the following of our clients:

Understanding, Empathy, and Patience: We are empathetic to our patients and clients and appreciate the same in return. Please understand that our team works with individuals and pets with varying levels of need and may, at times, need to prioritise their time accordingly. Our individualized approach to patient care relies heavily on equitable time management for all.

Zero-Tolerance Policy:
The following behaviours are not tolerated:

• Verbal abuse, malicious or harmful statements, profanity, or degrading comments directed at any staff member or fellow client.
• Any form of harassment, including but not limited to cyberbullying, discriminatory comments or actions, and intimidation tactics or threats.
• Refusal to pay for products and/or services.

This policy is strictly enforced. Non-compliance may result in corrective measures, up to and including being asked to leave the property and/or termination of the veterinarian–client–patient relationship.

Please understand that the health and well-being of your animal is our top priority, and we are committed to providing the best veterinary care possible. Thank you for choosing Hagersville Veterinary Services as your animal’s healthcare provider.

By signing below, I acknowledge that I have read and fully understand the above and agree to be bound by it. I understand that failure to comply may result in no longer being able to seek care for my animal(s) at Hagersville Veterinary Services.