Client Information 

    Permissions

    Telemedicine Client Agreement:  
    I authorize the Doctor(s) of Veterinary Vision of Rochester and their staff to examine, prescribe and treat my pet.  I give permission for Veterinary Vision of Rochester team members to discuss medical information via telephone, email and online video conferencing apps such as Skype.  I understand that the laws that protect privacy and confidentiality of medical information also apply to telemedicine. I understand that Veterinary Vision of Rochester updates my primary care veterinarian about our visits, so my pet’s whole medical team can work together effectively. I will tell Veterinary Vision of Rochester staff if I do NOT wish my primary care veterinarians to receive updates.  Otherwise, I understand that no information obtained during my telemedicine appointment will be disclosed to other parties without my consent.  
    By checking below I, the above named client, assume responsibility for all charges incurred in the care of my pet(s). I understand that full payment is due a the time services are rendered. In the event that payment in full is not made, I understand that I will be responsible for all service and attorney fees incurred in the attempt to collect payment.