Thank you for giving us the opportunity to care for your pet. Please complete all information
REASON DOB is Needed: Certain drugs used in veterinary medicine are closely monitored by the Drug Enforcement Administration (DEA) and require special record keeping. Information required for the use of these drugs is the date of birth of the pet owner, in addition to name and address. Additional Information can be found at www.vmb.ca.gov/enforcement/controlled_subs
I hereby authorize the veterinarian to examine, prescribe for, or treat the above pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required. I understand that this hospital does not accept checks. I understand that my pet must be examined before any medication can be prescribed or any treatment be made. I understand that I will not hold the veterinarian, the staff, or the hospital responsible for any incident which is beyond medical control.
