Co-owner's Name & Contact #
Please review the following items and select your preferred options. One selection must be made for each item for your registration to be accepted.
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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 understand that payment is always due IN FULL at the time of service. I recognize that financial concerns should be discussed PRIOR to exam & treatment. Our staff is happy to provide estimates.
*WE DO NOT ACCEPT PERSONAL CHECKS OR AMERICAN EXPRESS.
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I understand that typing my first and last name in these boxes constitutes a legal signature confirming that I acknowledge and agree to the terms above.