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New Client Registration

Owner Information
Spouse or Co-Owner Information
Pet 1
Pet 2
Pet 3
Pet 4

I hereby authorize the attending veterinarian at Prestige Animal Hospital to examine, prescribe for, and/or treat the pets described above. I assume all responsibility for the charges incurred for the care of these animals.I understand that in the event of any unusual or emergency circumstances, the staff will make attempts to contact me or my designated representative, if time allows, before proceeding with treatment. I understand that I will be financially responsible for, not only the estimated charges provided to me in person or over the telephone, but also for all emergency procedures. I understand that estimated/professional fees are to be paid at the time services are rendered and full payment/deposit is due on all pets admitted to the hospital. I also certify that I am at least 18 years of age.