31896 Plaza Dr Suite C-1, San Juan Capistrano, CA 92675 US
    949-201-4100

Emergency Care Authorization

Please fill out our Emergency Care Authorization & Deposit Form using one of the options to authorize emergency treatment at Veterinary Medical And Surgical Group–OC (VMSG-OC) in Orange County.

OPTION 1
Complete Online

Complete and submit the online form below.

OPTION 2
Print & Complete

Bring the completed form with you to our hospital.

Download Form

OPTION 3
Complete on Arrival

If you prefer, complete the form when you get to our hospital.

Emergency Care Authorization & Deposit Form

Please complete the following form. 

Owner Information & Contact

Emergency Care Authorization

The emergency doctor on duty will be working to stabilize your pet and provide you with information. The doctor may be relaying this information through the team. A written estimate for charges will be provided as soon as the doctor is able to create a treatment and diagnostic plan (estimate) for your pet’s visit.
We require authorization to perform emergency treatment. Emergency treatment charges vary. Your pet’s immediate care is started with an initial authorization deposit of $500.00 to $1000.00. These fees may include: Exam, IV catheter, fluids, emergency medications, X-Rays, CPR.

VMSG-OC is a critical care facility, and as such, all patients must have an emergency authorization form when in our care. This authorization clarifies for us what your preference is in the event of a life and death emergency (such as cardiac arrest). We will always attempt contact with you during a crisis. Please indicate your orders for the care of your pet:
By submitting this form, I grant permission to VMSG-OC to render emergency care if needed at a time that I cannot be reached and if CPR is performed there will be additional costs. CPR is estimated to range between $300 - $700. By submitting this form, I also acknowledge that no guarantee can be given or will be implied as to the outcome of treatment. I understand that I am financially responsible for the authorization given here.

New Patients Welcome

Veterinary Medical And Surgical Group–OC (VMSG-OC) accepts new clients to our specialty services and 24/7 emergency services.

Contact Us

949-201-4100