Owner Information

Please provide the information below as completely as possible. All information is strictly confidential.

Pet Information

PERMISSION TO TREAT, PAYMENT POLICY, ABANDONMENT

I hereby authorize Berryessa Veterinary Services to examine my animal and, after consultation with me, to prescribe for, treat, or perform surgery upon my animal. I understand that I assume financial responsibility for the balance of ALL services rendered on a cash, credit card, or check basis at the time of discharge. I also agree that I, or an authorized agent of mine, will call for and arrange to pay for all accrued charges on my animal within 5 days after receiving written or oral notification that he/she is ready to be released from the hospital. I agree that unless other arrangements have been made, if I fail to comply with this policy Berryessa Veterinary Services may humanely dispose of my animal.

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