• Client Information

  • Pet Information

  • NameSpeciesBreedColorDOB/ AgeSexNeutered/ SpayedMicrochip ID# 
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  • I hereby authorize the veterinarian to examine, prescribe for, or treat my pet. I assume responsibility for charges incurred during the care of my animals. I also understand that the charges will be paid at the time of release and that a deposit may be required for certain treatments. I understand that failure to comply will result in service and finance charges and as a last resort, court cost and attorney fees.
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