Veterinary Clinic
Patient intake, surgery and euthanasia consents, treatment estimates, discharge instructions, and boarding agreements for small-animal veterinary practices
Get started with PocperPatient intake, surgery and euthanasia consents, treatment estimates, discharge instructions, and boarding agreements for small-animal veterinary practices
Get started with PocperThis form outlines the recommended workup for your pet and how much it is expected to cost. Please review it with our team, tick the services you would like to authorise, and sign at the bottom.
Pet’s name:
Owner name:
Presenting problem / working diagnosis:
Tick each test you would like us to run. Your veterinarian will explain why each is suggested.
Complete blood count (CBC) & chemistry panel
Urinalysis
Faecal parasite screen
Heartworm / tick-borne disease test
Radiographs (X-ray)
Abdominal or cardiac ultrasound
Cytology / fine-needle aspirate
Blood pressure measurement
Injectable medications (antibiotics, pain control, anti-nausea, etc.)
Oral / take-home medications
IV fluid therapy
Hospitalisation with nursing care (per day)
Referral to a specialist or 24-hour emergency facility
Estimates are prepared in good faith, but your pet’s needs may change once we begin. If additional services become necessary we will contact you before proceeding.
Low-end estimate:
High-end estimate:
Deposit required today:
My pet has insurance — I will submit the claim myself after payment.
Please provide itemised invoices and medical records for my insurance claim.
Insurance provider & policy number:
If cost is a constraint, please tell us so we can prioritise the most important steps first.
Maximum you authorise us to spend without calling first:
I authorise the services ticked above and agree payment is due at the time services are rendered.
Thank you. We will keep you informed as our workup progresses.
The Treatment Plan & Financial Authorisation template is a ready-to-use form from Pocper's Veterinary Clinic pack. Customize the fields to match your workflow, then share a link so clients can complete it and upload documents in real time.