I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above described pet. I assume full responsibility for all charges incurred for 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 for treatment. I hereby authorize Flanary Veterinary Clinic, PLLC to photograph, take motion pictures, take video footage, and/or make electric sound recordings of me and my pet.
I authorize the use of any such photographic or electronic reproductions of me and my pet for any purpose. (I understand that I may be identifiable from such photographic and electronic reproduction). We will gladly give an estimate first.
