Day Admission Examination - Rodent/Rabbit

CLIENT INFORMATION

PET INFORMATION

My pet is (check all that apply):
If I cannot be reached at the above numbers, I authorize initial diagnostsics, including radiographs and bloodwork if indicated for my pet. I assume financial responsibility for these procedures. *

I, as the owner/agent for the above name animal, authorize and request an exam for my pet. I understand that sedation and/or pain medications will be provided if deemed necessary. I understand that the Veterinarian will contact me after he/she has examined my pet to discuss recommended diagnostics and treatment, and will have an initial estimate of charges before any treatment is done.
 

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