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Hospitalization Release Form - Chowan Animal Hospital

Monitored overnight hospitalization is not available at this facility

I understand that Chowan Animal Hospital will not be staffed during non-business hours.

*

I understand that Chowan Animal Hospital will not be staffed during non-business hours.

A

Yes

B

No

I decline transfer of my pet to a 24 hour facility.

*

I decline transfer of my pet to a 24 hour facility.

A

I decline

B

I do not decline

Owner Signature

*

Signature