• 3410 La Sierra Ave Suite A Riverside, CA 92503 - 951-359-7811 - info@lasierravet.com
  • Client Authorization Form

  • Client Information

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  • Pet Information

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  • By signing below, I confirm that I am the owner (or authorized agent of the owner) of above pet and authorize La Sierra Veterinary Clinic to perform services, diagnostics, treatments, and/or administration of extra label medications as deemed necessary by the veterinarian. I understand there is a risk of complication with any procedure and there is no guarantee as to the results of any treatment or procedure. I authorize La Sierra Veterinary Clinic to obtain/release all medical records regarding my pet from/to any other hospital associated with the care of my pet. I understand and agree that portions of my pet's visit may be recorded for educational purposes. I understand that payment is due in full at time of services rendered via cash, check, credit/debit card, Care Credit, and/or Scratchpay, and I am 18 years of age or older.

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