Sample

See What Your Client Sees

Three consents, the wording untouched, on a page that carries the practice name and colours. Nothing here submits: it is a picture of the real thing, not the real thing.

Sample only · Riverbend Animal Hospital is not a real practice

Requested the moment the patient is flagged for a procedure, so it is signed before the client reaches the counter on surgery morning.

Riverbend Animal Hospital(555) 010-4477

Surgery Consent

Please review and sign this consent before your pet's procedure. If you have any questions, call us. We are happy to walk through it with you.

First Name *

Last Name *

Street Address *

City *

State *

Postal Code *

Phone *

Email *

Patient's Name *

Patient's Date of Birth *

Patient's Age *

Patient's Breed *

Patient's Gender *

Color / Markings *

Neutered / Spayed *

Microchip Number (if applicable)

Other Pets in Household

I have read and understand the risks and consent to treatment *

By checking this box, I expressly consent to receive communications from Riverbend Animal Hospital at the phone number, email and other contact methods provided above.

Submit

On a live deployment these pages resolve your logo, your practice name, your phone number and your colours when they are sent, with no per-clinic page edits. The client signs from their phone and the record updates to Signed before they reach your counter.

Book a Walkthrough How the consent stack works

Bring Us the Consent Form You Use Today

Whatever your practice hands across the counter now, we will show you the same document as a link your client can sign from a phone.

Book a Walkthrough