Virginia Veterinary Disclosure Form

Important Information for Our Clients in Chester, VA and Surrounding Areas

At Dr. Johnson’s Mobile Veterinary Service, transparency and trust are at the heart of everything we do. As required by Virginia state law, all clients must review and complete the Virginia Veterinary Disclosure Form before veterinary services can be provided.

This form ensures that you are informed about how veterinary services are delivered, your rights as a pet owner, and our obligations as a licensed provider of mobile veterinary care.

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What Happens After You Submit the Form?

Once we receive your completed form, we’ll keep it on file for future visits and proceed with your pet’s scheduled care. If we have any questions or need further clarification, our team will contact you directly.

Why This Form Matters

The Veterinary Disclosure Form helps establish clear communication and mutual understanding between our team and you, the pet parent. It includes:

An overview of your rights as a veterinary client
Information about treatment recommendations and consent
Clarification on payment, scheduling, and emergency policies
Contact details for regulatory authorities, if needed

Completing this form ensures we can proceed with care during your scheduled visit.

Virginia Veterinary Disclosure Form

(Please Read Carefully Before Signing)

Dr. Johnson’s Mobile Veterinary Service, LLC is a housecall practice with business hours Monday, Tuesday, Wednesday, and Friday from 9 to 5 PM by appointment only. This business is a housecall practice, so continuous veterinary medical care is not provided at any time.

We do not provide any hospitalization services, and all after-hours emergencies are referred directly to your nearest Veterinary Emergency Clinic. As a housecall practice, we are not equipped to handle emergencies. If you have an emergency, please contact your nearest Veterinary Emergency Clinic immediately.

Any procedures that require anesthesia or radiographs will need to be performed at a full-service Veterinary facility.

The housecall/travel fee deposit is non-refundable unless you have given us at least 24-48 hours' notice prior to your scheduled appointment time. A deposit equal to the cost of your housecall/travel fee is required at the time of scheduling your appointment.

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Please be aware that telemedicine consults with the doctor may be available as an option for current clients only via texts, email, telephone or video chat for a fee. *

I have read this form and I am aware of the above office hours, missed appointment fees, telemedicine options and the limitation of this house call practice.

Today's Date *

Signature *

Clear Signature

Printed Name *

Email *

Question or Concerns?

If you have questions about the form, your rights, or anything else related to our mobile veterinary services, we encourage you to reach out. Our team is here to make sure you feel confident, informed, and supported.

Contact Us Online Call us at (804) 731-4119

Virginia Veterinary Disclosure Form

What Happens After You Submit the Form?

Why This Form Matters

Virginia Veterinary Disclosure Form

(Please Read Carefully Before Signing)

Question or Concerns?

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