Appointments Form

1. I hereby authorise the veterinarians and staff of Veterinary Fertility Services and Menlyn Animal Clinic to perform any reasonable treatment or anaesthesia and surgery they may deem necessary, including further or alternative measures as may be necessary during the course of the surgery and/or treatment of my animal.
2. I am fully aware of the reasonable risks involved with this procedure and treatment and indemnify the veterinarians, staff and clinic against any claim for damages of whatsoever nature arising out of this procedure and treatment which is performed in accordance with accepted principles and to the best of their ability.
3. I am aware that this veterinary facility does not provide 24-hour per day monitoring of patients. Should I wish to have my pet monitored 24 hours per day while hospitalised, I will make arrangements with the staff of this facility.
4. I undertake to keep in daily contact to enable the staff to inform me of the progress, costs incurred, and additional treatment involved, of my hospitalised animal.
5. I acknowledge that your account is payable upon presentation.
6. I acknowledge that I am indebted to the above practice for veterinary treatment, services rendered and expenses incurred therewith and hereby render myself responsible for all costs, telephone calls and legal expenses, as between attorney and own client, including collection charges that may be incurred in the recovery of the outstanding amount.
7. I agree that in the event that this matter is handed over to your Attorneys for collection I irrevocably agree to pay for all costs on an Attorney and Client scale, collection commission, (including the costs and collection commission of any correspondent Attorney employed by your Attorneys in connection therewith) and interest thereon at the rate of 2.5% per month.
8. I hereby choose the Residential Address referred to overleaf as my domicilium citandi et executandi.
9. I irrevocably consent to an Emoluments Attachment Order being issued against my current or future employers and do further undertake to pay any commission which my employers are entitled to deduct.
10. I irrevocably consent to the jurisdiction of the Pretoria Magistrate's Court or the Small Claims Court having jurisdiction at this address, and that all performance took place within the jurisdiction of these courts.