I hereby authorize the veterinarian and veterinary assistant(s) to examine, prescribe for, or treat the pet(s) described above. I understand that sedation/anesthesia may sometimes be needed and that there are inherent risks associated with sedation/anesthesia. I understand that vaccine reactions (vomiting, diarrhea, facial swelling, other) are rare, but can be serious. I assume responsibility for all charges incurred in the care of these pet(s). I also understand that all charges must be paid at the time services are rendered. *
Signature of Owner/Agent
