Pet Health History Form Page 3
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3Describe your pet's diet in detail, including any and all treats:
Consent
By submitting this form, I understand that I am authorizing the Veterinarian to examine,
prescribe for or treat the above described pet. I assume full responsibility for all charges
incurred in the care of this animal. I understand that charges must be paid at time of
service.
I agree
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Parent category: Medical