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  • Patient #1 Information

  • Date Format: MM slash DD slash YYYY
  • Patient #2 Information

  • Date Format: MM slash DD slash YYYY
  • In order to promote our business and pet health within the community, may we use images, videos, and/or information about your pet?
  • Payment Policy: We accept cash, credit, or check. Payment is expected when services are rendered. We will gladly prepare a written estimate of services prior to the treatment of your pet, if requested.

    I understand that I am financially responsible for the care and treatment of my pet(s). I further agree that in case of non-payment a finance charge and collection fee may apply.
  • Date Format: MM slash DD slash YYYY
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