I hereby authorize the veterinarian to examine, prescribe for and/or treat the pet described above. I assume responsibility for all charges incurred in the care of this animal. I understand that these charges must be paid at the time services are rendered and that a deposit may be required for surgical treatment. If I need to cancel any scheduled appointment or visit for diagnostic imaging I must give 24 hours notice or a $75.00 missed appointment fee will be charged. I understand that if I am late to a scheduled appointment that I may be required to reschedule and pay the missed appointment fee. If I need to cancel a scheduled surgery I must give 48 hours notice or 20% of the low end of the estimate missed surgery fee will be charged.