New Client Form

I, the undersigned, am the owner or agent for the owner of the animal(s) described, and I have the full and exclusive authority to execute this consent.

• I certify that I am 18 years of age or older.
• I give permission to doctors, staff, authorized agents, or representatives of this hospital to examine, prescribe for, and treat my pets.
• I agree to pay for all services rendered and medications, goods, and supplies when purchased.
• I understand that all fees are due at the time services are rendered and the hospital accepts cash, check, and all major credit cards.
• I understand that a deposit may be required for surgical or medical treatment.
• I understand that if my pet ever requires overnight hospitalization, there will not be overnight supervision provided.
• I release this hospital from any and all liabilities.

By my signature below, I hereby acknowledge that I agree to all of the above and acknowledge the receipt of a copy of this agreement upon request.