New Client/ Patient Registration

I hereby authorized the veterinarians & staff to examine, prescribe for, and/or treat the above-described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that any and all charges will be paid for at the time when the services are rendered and that a deposit may be required for hospitalization, treatment and/or surgery.

I understand that in order to protect my privacy, information regarding client and or patient information can only be released to the owners named above, and a medical record release form will need to be completed and signed by the above named owner(s).

NACOGDOCHES ANIMAL HOSPITAL DOES NOT OFFER BILLING, ALL PAYMENTS ARE DUE IN FULL AT THE TIME WHEN THE SERVICES ARE RENDERED.