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DOCTOR REFERRAL

If you have been referred to us by another veterinarian, please provide their information below.

PLEASE TELL US ABOUT YOUR PET(S)
PLEASE TELL US ABOUT YOUR PET(S)

I hereby authorize the veterinarian to examine, prescribe for or treat the above-described pet(s). I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges must be paid in full, at the time of release of the pet.

I agree