Veterinary Disclosure Form - Autumn Trails Veterinary

Virginia Veterinary Disclosure Form

(Please read carefully before signing.)
AUTUMN TRAILS VETERINARY CENTER, INC. has business and medical staffing hours as follows: 8am to 8pm, seven days a week, and is closed Holidays. Holidays effective are Thanksgiving Day, Christmas Eve, and Christmas Day.

Therefore, as required by the General Assembly of Virginia/Code of Virginia, Section 54.1- 3806.1, this is to inform you that we have no in-house, on-duty continuous medical staff care: 1) Overnight, from closing time at 8pm to opening time at 8am. 2) Holidays, from closing time before the holiday at 8pm, to opening time the day after the holiday at 8am.

I have read this form and I am aware of the above staffing hours.
Date*
MM slash DD slash YYYY
Printed Name*
Signed*

AUTUMN TRAILS VETERINARY CENTER, INC. has business and medical staffing hours as follows: 8am to 8pm, seven days a week, and is closed Holidays. Holidays affective are New Year’s Day, Memorial Day, Fourth of July, Labor Day, Thanksgiving Day, Christmas Eve and Christmas Day.

Therefore, as required by the General Assembly of Virginia/Code of Virginia, Section 54.1- 3806.1, this is to inform you that we have no in-house, on-duty continuous medical staff care: 1) Overnight, from closing time at 8pm to opening time at 8am. 2) Holidays, from closing time before the holiday at 8pm, to opening time the day after the holiday at 8am.

I have read this form and I am aware of the above staffing hours.

Date:

Printed Name:

Signed:

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