I hereby authorize the veterinarian to exam, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I also accept that I will be responsible for a cancellation fee of $25 dollars if 24 hour notice is not given before canceling or missing an appointment. I hereby grant Keystone Animal Hospital, LLC to take and post photos of my pet(s) on Facebook
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