Client / Owner Information
Address
About Your First Pet
Marketing
Doctor Referral
City and State

I hereby authorize the veterinarian to examine, prescribe for or treat the above-described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges must be paid in full, at the time of release of the pet. I authorize Briar Patch Veterinary Hospital to contact my previous veterinarian to obtain medical records prior to my appointment. 

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