Appointment Intake Form

As the owner (or authorized agent) of the above-described animal, I have the authority to execute this consent agreement. I consent to and authorize routine medical services as may be deemed necessary and desirable in the veterinarian’s professional judgment after today’s examination and my approval. I acknowledge that no assurance or guarantee has been made regarding the results of the above-referenced medical services and I accept financial responsibility for all fees charged to this account. A signed copy of this contract and any ancillary or supplement contract or document transmitted by facsimile, email, or other means of electronic transmission and any electronically signed version and delivered version of the contract, and any ancillary or supplement contract or document, shall be deemed to have the same legal effect as delivery of an original executed contract or document for all purposes.