AUTHORIZATION: I hereby authorize the veterinarians at PVRE to examine, treat and prescribe for the above describes pet(s I agree to assume responsibility for all charges incurred in the care of this animal. I understand that all of the charges incurred in the treatment of my pet will be paid in full at the time of discharge. We accept Cash, Visa, MasterCard, American Express, Discover, Debit Card, Care Credit, and Check. WE DO NOT BILL. In the event my pet has an outstanding balance I give my Permission to charge the balance to my credit card or debit card. I also understand that an estimate of these fees for veterinary services will be provided to me, and that I am encouraged to discuss all fees related to such care before services are rendered, and during my pet’s ongoing medical treatment. A prepayment of the estimated fee is required prior to any medical, surgical, or emergency care being provided. Please be advised the state of Arizona’s controlled substance prescription monitoring program requires your date of birth if controlled substances are dispensed to your pet. Prescription drugs may be available at your local pharmacy. PVRE participates with the Maricopa County Attorney’s Bad Check Program: consequently we will ask to make a copy of your Driver’s License. PVRE has doctors and nurses on site 24 hours a day, 365 days a year.
I have read, understand and agree with the above information.