CONSENT LETTER FOR ADMISSION AND/OR INTENSIVE MEDICAL TREATMENT

In this case, representing as the owner or authorized agent of the owner with full ownership right (further mentioned as a patient’s owner) of the pet described below:

I herewith declare that I fully agree and grant the Groovy Vetcare Clinic to provide treatment(s) on an inpatient basis for my pet (further mentioned as a patient). I understand that although all procedure(s) will be performed to the best of the abilities of the professional staff, no guarantee or warranty can be made regarding the results or cure, so I will not hold Groovy Vetcare Clinic, the veterinarians, or any staff liable if any undesirable circumstances occur. I declare further that I am willing to bear all costs of all services rendered and will obey the Groovy Vetcare Clinic’s hospitalization policies.

GROOVY VETCARE CLINIC’S HOSPITALIZATION POLICIES

• The minimum deposit is IDR 2.000.000, added to the total cost of the initial examination fee, treatment(s), diagnostic test(s), medication(s), and laboratory test(s) that have been done before the patient's admission.
• The vet will update the patient's condition via WhatsApp messages between 11:00 AM to 6:00 PM. Patients are monitored by inpatient staff periodically, and the presence of personnel to monitor the patient continuously may not be provided, especially during nighttime hours. Except for the patient stated by the veterinarian urgently requiring thorough treatments, the patient will be monitored intensively at an additional cost.
• Inpatient visits can be made every day except public holidays or the day the clinic is closed, and can only be made between the following hours:
  
  • Visitor hours in the main building from Monday to Saturday, 11:00 AM – 3:00 PM WIB.
  • Visitor hours in the infectious disease building from Monday to Saturday, 11:00 AM – 12:00 PM and 1:00 PM – 3:00 PM WIB
  • Special visiting hours on Sundays are from 11:00 AM – 1:00 PM and 2:00 PM – 3:00 PM WIB in both the main building and infectious disease building.
• The patient's personal belonging(s) left behind can be collected by the patient's owner a maximum of 7 (seven) days after the patient's discharge. After the time limit has passed, Groovy Vetcare Clinic is not responsible for any loss and damage to goods.
• The inpatient discharge established by the patient's owner and devoid of the veterinarian's consent requires a statement letter. Inpatient discharge time is every day between 11:00 AM to 4:00 PM. Patient pick-up made between 4:00 PM to 5:00 PM will incur an additional 1-day hospitalization fee plus a Late Check-Out fee if the pick-up is done after 5:00 PM. Payment in full is required at the time of patient discharge.
• The Finance of Groovy Vetcare Clinic will request an additional deposit if ongoing expenses while the patient hospitalized have neared or exceeded the earlier deposit and/or there are further treatment plans and/or other diagnostic tests proposed by the vet or requested by the patient's owner.
• Groovy Vetcare Clinic will limit or stop all treatments and diagnostic tests as long the patient’s owner has not added the deposit amount or paid off the bill for incurred costs. Deteriorating or lethal circumstances that occurred due to lack or break of treatment are not the responsibility of the Groovy Vetcare Clinic.
• 7 (seven) days after point 6 is executed, since the patient's owner has not made an additional deposit/payment for the costs incurred, the patient will be sent home along with the invoice and statement letter. The patient's return does not relieve the patient's owner from the obligation to pay off the bill. Disregarding the invoice and statement letter will lead the Groovy Vetcare Clinic to commence legal action according to Indonesian law.
• If there is no certitude from the patient's owner regarding the payment and return of the patient, and/or the patient's owner is unable to be reached within 14 (fourteen) days, then the patient shall be alleged to be abandoned. The Groovy Vetcare Clinic shall gain legal custody and ownership of the patient and retain the right to keep the patient, place the patient in a shelter/animal control, or put the patient in a new home with a new owner.

I give my consent to the Groovy Vetcare Clinic medical team to perform aggressive measures such as resuscitation (CPR), endotracheal intubation, establishing IV access, and administering oxygen, IV fluids, and medications, or other critical care to save the patient's life in the event that the patient stops breathing, has no heartbeat, or the patient experiencing any unexpected life-threatening situation. I understand that life-saving emergency care is required immediately. Hence if the attending veterinarian is unable to reach me, the hospital staff has my permission to provide such treatment. Regardless of the patient’s recovery or survival, I agree to pay additional expenses incurred to any estimated fees already identified and agreed upon by me.