I hereby authorize the veterinarian to examine, prescribe for, or treat the above mentioned pet. I assume responsibility for all charges incurred in the treatment/cure of the animal. I also understand that all professional fees are due at the time services are rendered. If my account becomes assigned to a collection agency, I agree to pay a 30% collection fee, interest in the amount of 1.5%, court costs, and attorney fees, as allowed by law. I understand that all accounts with a balance over 30 days will be assessed a 1.5% late charge per month on the unpaid monthly balance.
