I certify that I am the owner of the above animal, and/or have the exclusive legal authorization to act on the owner’s behalf for the above animal; I hereby give consent to the Doctor(s) and staff to handle, examine, diagnose and treat the above-named animal as they deem appropriate. I give permission for clinical photographs to be taken for educational and other medical purposes. I agree to assume all financial responsibility for any and all charges incurred on behalf of the above animal, including collection fees, interest, and other related fees. I understand that full payment is due at the time services are rendered.
