I am the owner / authorized agent for the owner of the animal being presented. I authorize the Center for Animal Referral and Emergency Services to examine and render immediate life saving treatment if necessary. I understand that no guarantee is made regarding the outcome of any diagnostics or treatment performed. I understand that I have the right to decline any of the diagnostics or treatment recommended by the attending veterinarian. I understand that I am making an informed financial decision on payment, that I agree to pay all fees associated with collection of the debt.
Owner/Agent Signature: _____________________ Date: ___________________ |