Owner Information
Patient Information
Method of Payment
Payment is due at the time service is rendered. No billing is offered.
                        *Stop payment/NSF of checks and/or charge back of credit cards fee is $30.00
 

I hereby grant to the veterinarian(s) in charge of the care of the patient described above, the authority to examine said patient in order to determine a course of treatment that he/she believes to be in the best interest of the patient. By agreeing to this examination, I consent to pay the fees associated with said examination, testing, and treatments. I also understand that further treatments, testing or procedures deemed necessary or advised will be performed only after I have granted permission whether by my actions in verbally agreeing that my pet be examined, tested, and/or treated; or by signing a consent form. My signature indicates that I am personally responsible for and will pay all charges incurred and I understand and will comply with Hill High Animal Hospital policy that requires payment in full at the time of service.

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