Client Information Form

Owner Information

Spouse or Partner

Emergency Contact

Cat(s)

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Financial Policy:
I hereby authorize the veterinarian to examine, treat, and prescribe for the above-described animal(s). I assume all responsibility for all charges incurred in the care of this animal. I understand that payment is due at time services are rendered and that there may be a deposit required for any hospitalized treatment. Acceptable forms of payment are cash, checks (up to the amount of $300.00), debit and credit cards (Mastercard/Visa/Discover) and Care Credit.