PAYMENT IS REQUIRED IN FULL AT THE TIME SERVICES ARE RENDERED. ACCEPTABLE FORMS OF PAYMENT ARE CASH, AMEX, VISA, MASTERCARD, DISCOVER, CARECREDIT, AND SCRATCHPAY (CHECKS WILL NOT BE ACCEPTED).
I hereby authorize performance of the above surgical procedure. The nature of such service has been described to me to my satisfaction and I realize that no guarantee no warranty can ethically or professionally be made regarding the results or cure.
I understand that I assume financial responsibility for all services rendered, and that payment is due upon hospital discharge of my pet.