(for healthcare reminders)
PET HEALTH HISTORY
(date and type of last vaccinations)
(problems and/or symptoms)
I hereby authorize to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal(s). I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment.
If you are paying with a check, you MUST provide a Drivers License or State ID to be photo copied.