+24 Hour Emergency Services

Tel: 2408 2588

Client Information Form


We recommend you complete this form prior to a visit to make check-in much simpler.

Please fill in all required fields.
IN CASE OF EMERGENCY PLEASE CALL +852 2408 2588.
 

I, the undersigned owner of, agent of the owner of, or Good Samaritan responsible for seeking veterinary care for the pet identified above

I consent to the examination of this pet by veterinarians at Veterinary Specialty Hospital. I also agree that after consultation with me, the hospital’s doctors may prescribe medication for, treat, hospitalize, sedate, anesthetize and/or perform surgery on my pet. I understand that some risks always exist and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure is initiated. Should unexpected lifesaving emergency care be required and the attending veterinarian is unable to reach me, the hospital staff has my permission to provide such treatment, and I agree to pay for such care. I understand that an estimate of the fees for veterinary services may be provided to me and that I am encouraged to discuss all fees related to such care before services are rendered and during my pet’s ongoing medical treatment. I understand that payment is due when services are rendered and if my pet is hospitalized, I agree to pay a deposit of the lower end of the estimated range. I agree to assume full financial responsibility for all fees, regardless of the outcome, and will provide payment via cash, check, or credit card (Visa, MasterCard) at the time my pet is discharged from the hospital. I agree to pay a monthly billing and financing fee of any unpaid balance.

By submitting this form, we collect your personal data for the Purposes defined in Personal Information Collection Statement.  We may also use your personal data for direct marketing purpose, by providing you with information or materials we think may be useful or relevant to you, information about the products and services of VSH, and the latest promotional information of VSH, provided we have obtained your consent below.

 

Personal data provided by you will be used strictly in accordance with the Personal Information Collection Statement and Privacy Policy Statement.

By checking this box, I consent to the use of my personal data by VSH and its third-party contractors or service providers for direct marketing purpose, by providing me with information or materials VSH considers useful or relevant, information about the products and services of VSH, and the latest promotional information of VSH.

I have read, understood and agreed to the Personal Information Collection Statement and Privacy Policy Statement.

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Hong Kong Island

VSH Hong Kong
G/F - 2/F
165-171 Wan Chai Road
Wan Chai, Hong Kong

 

EMERGENCY TEL: +852 2408 2588

Kowloon

VSH Kowloon
G/F - 1/F
7 Liberty Avenue
Ho Man Tin, Kowloon

 

EMERGENCY TEL: +852 2408 2588