Advanced Directive Form

Please complete this form before your visit.

We understand these questions may be difficult, but your answers are essential to ensure that we provide the best care to each patient in the event of an emergency while meeting the expectations of our clients. Please do not hesitate to ask if you have any questions or would like to speak to a member of our team about the treatment that may be provided.


Emergency and stabilization care can cost $500 or more. This is only for the initial stabilization of your pet. Further treatment and diagnostics will likely be necessary and will accrue additional charges. If stabilization and/or resuscitation is successful, many patients will require extensive monitoring and care, and may never make a complete recovery.

I understand that Novey Animal Hospital will make every reasonable effort to contact me, while my pet is stable. I understand that if I select “DO NOT” above and I am unreachable, that my pet may die due to the severity of its illness.

Being of sound mind, I voluntarily authorize this directive for my pet listed above, and I understand its full import. If I decline to choose an option, then I understand that Novey Animal Hospital and its staff are ethically and legally obligated to provide stabilization care until I can be contacted and that I will be financially responsible for that care.