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Address*
Pet Information
Name
Breed
Age
Sex
Spayed/Neutered
Medications
Previous Vet
 

Social Media/Photo Permission:

Do we have your permission to post photos of your pet online and/or use it for marketing purposes?*
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Authorization

I hereby authorize the veterinarian to examine, prescribe for, and/or treat my pet(s). I assume responsibility for all charges incurred in the care of my pet(s). I also understand that charges are to be paid at the time of service.
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