Admission Form


As the owner or authorized agent of the Patient, I certify that I am over the age of 18 years. I understand that I am financially responsible for all charges, including all charges associated with collection of an unpaid balance, at the time my pet is picked up from Glen Eagles Pet Hospital. 

I hereby authorize the Doctor and Staff of Glen Eagles Pet Hospital to examine, diagnose, perform diagnostics, administer treatments, and prescribe medications as agreed upon. 

I understand that my pet must be current on the required vaccinations (DAPPvL, Rabies, Bordetella), and intestinal parasite deworming (pyrantel pamoate), and it is my responsibility to provide documentation of proof. If my pet is not current, I authorize the Doctor and Staff of Glen Eagles Pet Hospital to administer what is necessary to comply.

I understand that the safety of my pet is a concern of the Doctor and Staff of Glen Eagles Pet Hospital, therefore in the event of an emergency, I hereby authorize them to administer any medications and/or perform any lifesaving emergency procedures for/or on my pet. This may include anesthesia, surgery and/or other procedures and treatments. I understand that with exception of urgent or emergency/life-saving efforts, the staff will exhaust every effort to contact me and to provide me with an estimate of charges prior to the performance of procedures.      

 As soon as the Doctor or Staff of Glen Eagles Pet Hospital notifies me that my pet is ready for pick up, I will do so by 7 p.m. If I have not picked up my pet within 72 hours of notification, my pet will be considered abandoned, and transfer of ownership will be given to Glen Eagles Pet Hospital.  

Sign above