Client Forms

I am requesting a copy of my pet's medical record to be released from the Back Bay Veterinary Clinic. *

Would you like to receive text message/picture message updates *

By checking ALL of the the boxes below, you grant permission for Back Bay Veterinary Clinic to perform the recommended service(s) and fully acknowledge and accept risks associated with sedated procedures. *

I understand that the attending veterinarian will make every effort to contact me regarding treatment in the case of unforeseen emergencies. If unable to contact me, the staff may or may not have my permission to proceed with life sustaining procedures such as CPR. *

I do hereby certify that I am the owner or the duly authorized agent for the owner of the animal described above, that I do hereby give the doctors of Back Bay Veterinary Clinic permission to euthanize and dispose of said animal in whatever humane manner the doctors of Back Bay Veterinary Clinic, their agents, servants or representatives deem appropriate. I also release the doctors, Back Bay Veterinary Clinic, their agents, servants and representative from any and all liability for so euthanizing and disposing of said animal. *

Has this pet bitten any person or domestic animal during the last ten (10) days? *

Has this pet been exposed to possible infection with rabies through a bite from another animal during the last ten (10) days, or is this pet currently under a rabies quarantine? *

Please select one of the following for disposition of remains *

By checking the boxes below you grant permission for Back Bay Veterinary Clinic to perform the recommended service(s) and fully acknowledge and accept risks associated with anesthesia and surgical procedure(s). *

I understand that the attending veterinarian will make every effort to contact me regarding treatment in the case of unforeseen emergencies. If unable to contact me, the staff may or may not have my permission to proceed with life sustaining procedures such as CPR. Please note that recovery rates after CPR under anesthesia are better than rates after CPR due to illness or trauma. *