By completing this form and clicking submit, you are acknowledging the following:
My veterinarian has offered me the option of a Telemedicine Consult as an option in seeking medical advice for my pet. This consultation may take the form of a phone call or Zoom conference and will result in my veterinarian making a clinical assessment of my pet from a different location to myself.
I am undertaking this consultation with the understanding that there are limitations to what my veterinarian can deduce about my animal’s condition without a physical examination and/or other detailed investigations best done in the clinic. To minimize the risks of errors of clinical judgement my veterinarian may recommend that my pet attend the clinic and/or undergo further diagnostic tests. This will then be up to me to decide if I proceed.
I understand that if my pet is suffering from an urgent or emergency medical conditions (trouble urinating, seizures, severe vomiting or diarrhea, trouble giving birth, active bleeding, paralysis, infected wounds, problems breathing) that emergency care is recommend as soon as possible and virtual visits are not appropriate for those situations.
I understand that it is my responsibility to contact my veterinarian and/or attend the clinic (or nearest emergency hospital) if my pet’s condition persists or deteriorates unexpectedly.
I understand that payment for my consultation is required prior to the virtual visit and that the cost of my Telemedicine consultation does NOT include payment for other services, examples of which include but are not limited to such things as drugs, medications, tests, surgery, procedures, diagnostics, referrals to specialists, hospital care, etc. If other services are recommended by my veterinarian, I understand that they will provide me with a written treatment plan listing these things and an estimate for costs.
I understand that I am consulting with one the veterinarians employed with First Coast No More Homeless Pets (FCNMHP) who are all registered veterinary practitioners in the state of Florida. I also confirm that my details including my stated residence in the state of Florida are correct.
I agree to RELEASE OF INFORMATION from FCNMHP to any other veterinary care facility or provider to which my pet’s care may be transferred.