All reasonable precautions will be used against injury, escape, or death of my pet, but you will not be held liable or responsible in connection therewith, as I assume all risks. I, being responsible for the above animal, have the authority to grant my consent to receive, prescribe for, treat and/or operate upon my pet. I understand that I assume financial responsibility for all services and the balance is due in full at the time of service.
I understand if I do not make with Richland Animal Clinic within ten days of the day my pet is scheduled to be picked up, the animal will be considered abandoned and may be disposed of as the doctor sees fit. This does not relieve me from paying all costs of all services for the duration of the pets' stay at Richland Animal Clinic, including boarding.
Terms: BALANCE IS DUE IN FULL AT THE TIME OF SERVICE
As the owner, or authorized agent of the pet listed above, I hereby give my consent to the veterinarian(s) and/or trained veterinary personnel at Richland Animal Clinic to perform the necessary testing and/or procedures as discussed. My signature on this form indicates that any questions I have regarding the procedure, recovery, or potential complications have been answered to my satisfaction.
I have carefully read, understand, and agree to all of the above: