I hereby authorize Butterfield Animal Hospital to examine, treat, and provide necessary care to the above described pet. Should my pet require boarding or hospitalization, I agree to pick up my animal when he/she is ready for release. Failure to retrieve my animal within 5 (five) days of notification that he/she is ready for release will deem the pet abandoned and require Butterfield Animal Hospital to handle the animal in accordance with the California Abandoned Animal Act. Abandonment of an animal does not release the owner or agent of financial responsibility for that animal.

I, the undersigned, agree as owner or agent that in consideration of treatments and services rendered for the above described patient. I obligate myself to pay all fees incurred at time services are rendered.

Butterfield Animal Hospital does not offer billing. Payment is due at time services are rendered.

I certify that I am at least 18 (eighteen) years of age and that I am the owner or owner's agent of the above described animal and am duly authorized to execute the above and accept its terms. I understand that there is no guarantee of successful treatment and that no such guarantee has been made or offered.