I hereby authorize the veterinarian to examine, prescribe for or treat the above-described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges must be paid in full, at the time of release of the pet.
Please note: Submitting this form does not guarantee or confirm an appointment. A member of our front desk team will be in touch shortly to finalize scheduling and confirm your appointment time. We look forward to speaking with you!
This fee is waived when paying by cash or PIN debit as part of our cash discount incentive.
Thank you for your understanding and support!
