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About
Services
Online Pharmacy
Careers
Request an Appointment
Consent to Treat
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I hereby authorize Iowa Equine LLC to provide medical treatment to my horse.
Horse's Name(s)
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Consent to Treat
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I agree
Treatment Authorization: I understand that veterinary treatment may include, but is not limited to, medical examinations, diagnostic tests, surgical procedures, medications, therapies, and any other necessary treatments deemed appropriate by the veterinarians of Iowa Equine, LLC.
Risks and Benefits: I acknowledge that I have been informed of the potential risks and benefits associated with the proposed treatment. I understand that there are no guarantees regarding the outcome of any treatment, and I accept all risks involved.
Financial Responsibility: I understand that I am financially responsible for all charges incurred for the veterinary services provided to my horse. I agree to pay for all services rendered by Iowa Equine, LLC at the time services are rendered. I understand and agree to pay an APR of 18% on any balances that are not paid in full within 30 days.
Emergency Contact: In case of an emergency, I authorize Iowa Equine, LLC] to take any necessary action for the well-being of my horse, including, but not limited to, life-saving procedures.
Authorization for Procedures: I understand that in the course of treatment, unforeseen circumstances may arise, requiring additional procedures or treatments. I authorize Iowa Equine, LLC to perform any additional procedures that they deem necessary for the health and well-being of my horse.
Photo/Video Release: I do grant Iowa Equine, LLC the right to take photographs or videos of my horse during the course of treatment. I understand that these images may be used for educational, promotional, or documentation purposes.
Ownership Verification: I affirm that I am the legal owner or authorized agent of the horse named above and have the right to provide consent for veterinary treatment.
Confidentiality: I understand that my personal and horse's medical information will be kept confidential, and it will not be disclosed to any third party without my consent, except as required by law.
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