(please check all that apply)
ALL FEES ARE DUE UPON COMPLETION OF SERVICES
I hereby authorize the examination, prescription for, and/or treatment of my pet(s). I assume responsibility for all charges incurred in the care of this/these pet(s). I agree to pay all fees for all services rendered at the time the pet(s) is/are released from our care. Failure to pay on an active balance will result in a 15% service charge.