Authorization For Treatment and Credit Agreement
I hereby authorize the Veterinarian(s) 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 are due at the time services are rendered. If a balance is unpaid after services are rendered, I agree to pay a service charge of five percent (1.5%) per month computed on the unpaid balance until the account is paid in full. I also agree to pay all attorney fees, collection agency fees, court fees and all other costs incurred in our collection process on all unpaid balances I may owe.
I understand that if anyone else other than myself brings in my pet or picks my pet up, then they need to be responsible to pay the bill in full when the services are rendered or prior to the release of the animal.