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AUTHORIZATION: 

1. I am the owner/authorized agent of the animal(s) identified above and I hereby request that the veterinarians, agents, and employees of The Andys Veterinary Clinic Limited perform the services which are necessary to the examination, medication and treatment of the animal(s) specifically described and identified on this form. 

2. I also authorize the veterinarians on duty (and the designated assistants) that they may prescribe medication for, treat, hospitalize, sedate, anesthetize and/or perform surgery on this animal or emergency surgical treatment which is considered therapeutically and/or diagnostically necessary based on the findings during the examination and desirable in the exercise of the veterinarian’s professional judgment. 

3. I also consent that should some unexpected life-saving emergency care be required, and the attending veterinarian is unable to reach me, the hospital staff has my permission to provide such treatment and I agree to pay for such care.

4. I further understand that any animal found to be infected with either external or internal parasites will be treated for the same at my expense.

5. I understand that the treatment of the patient will be conducted with due care and in accordance with the prevailing standards of competency in Veterinary Medicine. I certify that no guarantee or assurance has been made as to the results that may be obtained through the course of treatment undertaken by the veterinarians, agent, or employees of The Andys Veterinary Clinic Limited.

6. I understand that a written estimate of charges is available within reasonable time at my request, and I assume full financial responsibility for all charges incurred to the patient for services rendered and understand that full payment is required upon discharge. In case of non-payment, I am aware that The Andys Veterinary Clinic Limited will charge a 5% interest on the amount owed as the cost of collecting the debt for services rendered.