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I, the undersigned, authorize the veterinarian(s) and staff employed by Old Mill Veterinary Hospital to examine, prescribe for and treat accordingly up to and including medical surgical procedures for the patient/s specifically described and identified above.
I assume responsibility for all charges incurred for services rendered to the patient/s.
Also, I understand payment is due when services are rendered. Deposits may be required for some services.
There are additional fees assessed for non-payment, returned checks and accounts sent to collection. I understand and agree to pay these fees.