Patient/Client Information Form

We will gladly prepare a written estimate if you desire. Please ask the receptionist or doctor.
PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED.

ANIMAL MEDICAL CENTER IS A FLEA FREE FACILITY. ALL ANIMALS ENTERING THE KENNEL WILL BE GIVEN A $6.50 CAPSTAR AT OWNER'S EXPENSE. TO PREVENT THE SPREAD OF INFECTIOUS DISEASES AND PARASITES, HOSPITALIZED AND BOARDED ANIMALS MUST BE CURRENT ON ALL VACCINES AND FREE OF INTERNAL AND EXTERNAL PARASITES.

I authorize the doctor to provide vaccines and parasites control as needed for my pet. I give permission to have my pet's likeness and/or picture and medical story posted on social media. I assume responsibility for all charges 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 treatment. I understand that if I do not pay for services as agreed, I agree to pay all costs of collection.