Veterinary Against Medical Advice Form - When a client chooses to give up ownership of a pet, dr. Short offers him or her this form to sign. Short says, but we use it only as a last resort. 8. Medical examination, treatment, or testing has been recommended for me. Web in the event any adverse medical problems (including death) occur because of my decision to remove my pet from this facility, i accept full financial and medical responsibility for my decision and hereby release veterinary specialists of the rockies, its staff, and contracted agents from all responsibility and liability for that choice. Web we ask the client to sign this form acknowledging the risks, dr. She includes it in the client's records to document the finality of the situation. Patient authorization and notice _____ _____ patient name date _____ _____ time of visit office location. I have decided to reject further treatment or medicalevaluation, and will leave the facility.
I have decided to reject further treatment or medicalevaluation, and will leave the facility. Short says, but we use it only as a last resort. 8. Patient authorization and notice _____ _____ patient name date _____ _____ time of visit office location. Web we ask the client to sign this form acknowledging the risks, dr. Short offers him or her this form to sign. She includes it in the client's records to document the finality of the situation. Web in the event any adverse medical problems (including death) occur because of my decision to remove my pet from this facility, i accept full financial and medical responsibility for my decision and hereby release veterinary specialists of the rockies, its staff, and contracted agents from all responsibility and liability for that choice. When a client chooses to give up ownership of a pet, dr. Medical examination, treatment, or testing has been recommended for me.