Form Page – Pet Veterinary Clinic PC

Client Rights and Responsibilities

Client Rights and Responsibilities
At Mountainside Animal Hospital, our mission is to provide the highest standards of health care to the pets we serve, while empowering pet owners through education for a healthier, better tomorrow.
Your Rights
✔ To be treated with professionalism, compassion, honesty, and respect, free from discrimination.
✔ Our priorities are your pet’s well-being, your needs, and public safety.
✔ Knowledgeable, high-quality veterinary care for your pet.
✔ Clear, comprehensive information so you can make well-informed decisions for your pet.
✔ The right to request a written prescription or your pet’s medical records.
✔ Privacy and confidentiality, unless you request otherwise or disclosure is required by law.
✔ A welcoming attitude toward your feedback, whether positive or constructive.
✔ Notice, referral contact information, and assistance in transferring your pet’s care if we are no longer able to provide services.
Your Responsibilities
Please agree to each box to acknowledge
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To treat our team and fellow clients with professionalism, compassion, and respect, free from discrimination. We have a zero-tolerance policy for abusive behavior toward our team.
I agree.
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To be honest and transparent with our team, including:
○ Providing (or authorizing us to request) your pet’s complete medical records.
○ Truthfully answering questions and sharing any relevant health history.
○ Informing us if your pet has a history of aggression (e.g., biting, scratching, fear-based behavior).
○ Asking questions and sharing any concerns or challenges related to your pet’s care or our
recommendations.
I agree.
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To respect our schedule and understand that medical care can be unpredictable.
○ If you need to cancel or reschedule, please call, text, or leave a voicemail at least 24 hours in advance. This allows us to accommodate other patients in need.
○ A verbal courtesy reminder will be given for the first late cancellation (<24 hours), but further occurrences may result in fees or require pre-payment to schedule future appointments.
Definitions:
○ “No Show”: Failure to arrive for a scheduled appointment.
○ “Late Cancellation”: Cancelling less than 24 hours in advance.
○ “Late Arrival”: Arriving 10 minutes or more past your appointment time. This may result in rescheduling.
I agree.
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New Clients: A deposit (equal to the cost of the exam) is required when scheduling. This is refundable with at least a 24-hour notice of cancellation.
I agree.
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Only send individuals you trust to:
○ Receive information,
○ Make medical decisions, and
○ Handle payment for your pet’s care.
Please note: Due to time constraints, we cannot repeat discussions with multiple parties. If repetition is required, a fee may apply.

I agree.
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Payment is due at the time of service.
We accept:
○ Visa, Mastercard, American Express, Discover
○ CareCredit, Scratchpay
We do not accept cash or checks.
○ In-clinic payment plans are available for Preventive Care Plans only.
I agree.
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Provide genuine feedback.
We welcome your input. Please bring any concerns directly to our team or practice leadership so we can improve the experience for all clients and patients.
I agree.
Referring friends and family is the highest form of compliment we can receive, and we are truly honored by your trust. Thank you for helping us care for more pets in our community.

Client Rights and Responsibilities

Client Rights and Responsibilities

Your Rights

Your Responsibilities