Establishing, Maintaining, and Discontinuing a VCPR

Professional Practice Standard

Published: July 2016

Revised: April 2020, December 2022

Practice Expectations 

A veterinarian meets the Professional Practice Standard: Establishing, Maintaining, and Discontinuing a Veterinarian-Client-Patient Relationship (VCPR) when they:  

Establishing a VCPR 

1. Understand that a VCPR must be established by a veterinarian.  
2. Understand that a veterinarian can choose when they enter into a VCPR.  
3. Establish a VCPR prior to providing clinical veterinary services (including the prescribing, dispensing, or administering of drugs) for an animal(s) or group of animals.  
4. Understand that a VCPR is a relationship established between a veterinarian and a client for the provision of veterinary services to a specific animal(s) or group of animals.  
5. Understand that a VCPR is established when the veterinarian:
   - has been retained by the client;  
   - has reached an agreement with the client as to the scope of services to be provided by the veterinarian; and  
   - has advised the client that services will only be provided in accordance with the standards of the practice of the profession.
6. Inform the client of any additional associated conditions of the VCPR including how the VCPR will be maintained.  
7. Consider establishing a VCPR in writing in circumstances where there is increased complexity to ensure both parties understand the scope of services to be provided.  
8. Understand and communicate to a client that has an existing VCPR with another veterinarian licensed in Ontario, that to ensure continuity of care, a veterinarian may only treat an animal(s) or group of animals after:  
   - notifying the other veterinarian that is providing care to the animal(s) or group of animals that they will be providing care and obtaining relevant historical information from said veterinarian as soon as possible; and
   - advising the client that treating an animal(s) or group of animals that is receiving care from another veterinarian who did not provide a referral that such uncoordinated services may place the animal(s) or group of animals at risk.  

Maintaining a VCPR 

9. Understand that once a VCPR has been established it can be maintained by either the veterinarian who established the VCPR or by any other veterinarian that is associated with the same accredited facility where the VCPR was established.  

10. Understand that after establishing a VCPR they are required to obtain the client’s informed consent for each specific service or group of services to be provided in accordance with the Professional Practice Standard: Informed Client Consent.  

11. Understand that a veterinarian is expected to maintain recent and sufficient knowledge of an     animal(s) or group of animals to make a general or preliminary diagnosis or to prescribe, administer, or dispense a drug in accordance with the Professional Practice Standard: Prescribing a Drug and the Professional Practice Standard: Dispensing a Drug.  

12. Understand that a veterinarian is responsible for providing reasonably prompt services outside of their regular practice hours if the services are medically necessary for animals they have treated recently or they treat regularly in accordance with the Policy Statement: After-Hours Care Services.  

Discontinuing a VCPR  

13. Understand that the VCPR most often concludes when the scope of services agreed upon between the veterinarian and the client are completed. Outside of these circumstances, understand that a veterinarian may choose to discontinue a VCPR for a variety of reasons and that discontinuing a VCPR requires clear communication with a client, including adequate notice of the discontinuation of a VCPR, allowing the client a reasonable amount of time in which to arrange care with another veterinarian including the appropriate transfer of medical information in accordance with the Professional Practice Standard: Medical Records.  

14. Understand that a request for the transfer of medical records is tied to continuity of care and does not automatically indicate the discontinuation of a VCPR.  

Exceptions to the Requirement for a VCPR 

Exceptions to the requirement that a VCPR must be established before a veterinarian can provide veterinary services (including prescribing, dispensing, or administering drugs) may exist in some circumstances. These include where a veterinarian:  

1. Acting reasonably, determines that there is an emergency situation and that an animal or animals require(s) immediate veterinary services; 
2. Is an employee or contractor of the Crown in right of Canada or the Crown in right of Ontario and is providing veterinary services as part of that employment or contractual relationship; 
3. Is providing veterinary services in or from a temporary facility;3 
4. Is providing veterinary services that are permitted or required under the Dog Owners’ Liability Act, the Animals for Research Act, the Provincial Animal Welfare Services Act, the Animal Health Act, 2009 or under any other Act except for the Veterinarians Act; 
5. Is retained or employed by a person other than an animal’s owner to conduct an independent examination of the animal and report on the animal’s health to that person; or 
6. Administers or dispenses a drug pursuant to a prescription (other than for a controlled substance):

• that was issued by another member where it is not reasonably possible for the client to obtain the drug from the prescribing member; 
• where it is necessary in the animal’s interests to dispense without delay; 
• where they made a reasonable effort to discuss the matter with the prescribing member; 
• where a sufficient assessment of the animal’s circumstances is carried out; 
• where the quantity of the drug dispensed is no more than would reasonably enable the client to return to the prescribing member for future prescriptions; and 
• where they make a written record of the transaction.

_{College publications contain practice parameters and standards which should be considered by all Ontario veterinarians in the care of their patients and in the practice of the profession. College publications are developed in consultation with the profession and describe current professional expectations. It is important to note that these College publications may be used by the College or other bodies in determining whether appropriate standards of practice and professional responsibilities have been maintained. The College encourages you to refer to the website (www.cvo.org) to ensure you are referring to the most recent version of any document.}