Please choose one of the following statements:
I understand that if my pet(s) need treatment while I am away (see the dates above), that I will incur service fees by the Morris Animal Hospital for medical expenses that my pet(s), listed on page 2, may require. Please check one of the following:
By signing below, you are authorizing responsibility for charges for any and all services incurred for your pet(s) while you are away.
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