New Patient Form

Authorization

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 surgical treatment. I authorize Gailor Animal Hospital to use photographs of my pet for purposes of publicity, advertising, web content, and/or the Gailor Facebook page.