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    Please fill out this form prior to your pet's appointment!
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  • I hereby request that my pet's medical records be released to:

    Southern Hills Veterinary Hospital

    38 Clinton Street

    Tully, NY 13159

    infotullyvet@gmail.com

    Fax: 315-696-6680

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  • I hereby authorize Southern Hills Veterinary Hospital to render surgical and/or medical care for my pet(s). I understand that payment is due in full at the time services are rendered. I/we understand and agree that any credit granted shall be paid promptly in accordance with terms and agreements, that the credit grantor may add a $35 late fee for any balances not paid one month after services rendered, and in the event of default to pay reasonable collection charges and/or attorney fees.

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