New Patients & Referrals
Release of liability and authorization to perform rehabilitation therapy.
I hereby authorize Julie Sowa DVM, cVMA, cVSMT, CCRP of Pawlouse Veterinary Rehabilitation to examine and provide treatment to my pet listed above. Therapeutic treatments that may be performed on my pet may include one or a combination of the following: Veterinary Acupuncture; Veterinary Spinal Manipulation (aka chiropractic care); Therapeutic Laser; Extracorporeal Shockwave Therapy; Strength and Mobility Training; and Underwater Treadmill Therapy. I understand that treatment may also include the administration of pain medications and dietary supplements. I acknowledge that the nature and purpose of the procedures, possible alternative methods of treatment, risks involved, and possible complications have been fully explained to me. I also understand that if therapeutic exercises are recommended for my pet, that I will be responsible for the home delivery of said exercises. I further understand and acknowledge that no guarantee or assurance has been made as to the results of the treatment that may be made. I release Dr. Sowa and Pawlouse Veterinary Rehabilitation from all liability related to such treatments of my pet.
Our staff is scheduled accordingly to provide a good experience for your pet. We will always try to accommodate your schedule. As a courtesy we request that you provide us with at leas 24-hour notice if you need to cancel or reschedule your appointment. We understand emergencies happen and we will do our best to accommodate these, but we will bill you the full price of your missed visit if the cancellation was not made without proper notice, or if you fail to show up for your scheduled appointment. If you are on a package plan, the missed visit will be deducted from the package accordingly.
Your signature indicates your understanding and agreement of our policy. Thank you for selecting Pawlouse Veterinary Rehabilitation, and we look forward to working with you and your pet!
Would you like to consent to the use of you and / or your dog's photography, videography or the like, being utilized on social media?
Thank you for submitting, we'll get back to you shortly!