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 VIP Animal Hospitals to use
photographs of my pet for purposes of publicity, advertising,
web content, and/or the VIP Facebook page.