New Client / Patient

I am 18 years of age or older, the owner or agent of the above-described pet(s) and have the authority to execute this consent form. 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 will be paid at the time of release and that a deposit may be required for surgical/medical treatment. A finance charge of 2.0% will be added to any account more than 30 days past due. A fee of $35.00 will be applied to your account for any returned checks. If we are required to submit your account to a collection agency, a $25.00 fee will be applied.