I certify that I am the owner/gaurdian of the above mentioned animal. I hereby authorize the staff of Emergency Veterinary Services to examine my pet. I also authorize recommended testing, treatment, medications, or surgery after consultation with me by the staff of Emergency Veterinary Services.
I assume full financial responsibility for all charges incurred for the services/treatment/medications provided by Emergency Veterinary Services. I understand that the entire balance must be paid in full at the time of discharge, billing is not available. If my pet requires hospitalization I will be provided an estimate. A deposit for the low end of the estimated charges will be required at admission.