I hereby consent and authorize the veterinarians at Parkway Animal Hospital to perform such diagnostic, anesthetic, and/or surgical procedures as are, in their opinion, necessary and advisable for the treatment and maintenance of my pet's health.

I understand that anesthesia involves risks in addition to those involved with the recommended surgical, medical, or diagnostic procedures, but I request the use of anesthetics for the relief and protection of my pet from pain during the planned and any additional procedures.

I understand that an estimate of the costs for veterinary services has been provided to me, and I am encouraged to discuss all fees attendant to such care during my pets on-going medical treatments. If my pet is hospitalized, a deposit of 50% for the estimated services may be required. I will assume full finanical responsibility for the balance of all services rendered when my pet is discharged. Methods of payment are cash, care credit, check and accepted credit cards. In the event of an open balance, all accounts will accrue an interest of two percent (2%) per month and a $2.00 monthly billing fee. All accounts placed for collections will be charged attorney fees of thirty-five percent (35%) of the total balance due.

Parkway Animal Hospital requires that all pets admitted to our facility be currently vaccinated for Rabies and the appropriate canine or feline vaccines. If vaccinations cannot be verified or they have not been given, we will administer those vaccinations at an additional fee. We reserve the right to treat any animal in our hospital for fleas and ticks, in order to protect our facility and patients. There will be a minimal fee for this service.

After receiving written or oral notification that my pet is ready for release, if the pet has not been picked up within ten (10) days, Parkway Animal Hospital will consider this abandonment. At that time, the pet will become property of Parkway Animal Hospital.

Consent

I have read and understand the above recommendations; I hereby authorize the veterinarians at Parkway Animal Hospital to perform the procedures as indicated below.

PETS NAME: _______________________ DATE: ________________

PROCEDURES TO BE PERFORMED: _______________________________

SIGNATURE OF OWNER OR AGENT: ______________________________

PHONE NUMBER: ____________________