Owner Information

Pet Information

If yes please provide ID#. If no, but would like one, write: "Microchip requested."

Authorizations

Authorizations

Please Initial to confirm that you received and agree.
I hereby give permission for the treatment/surgery for my pet and approve the estimate of services. I UNDERSTAND A 50% DEPOSIT IS REQUIRED AT THE TIME OF MY PET’S ADMITTANCE.
By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement and the Disclaimer. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing.
The individual signing this document represents that he or she is the owner (or agent of the owner) of the animal described above. I understand that by signing this document I am assuming full financial responsibility for all services rendered by Bull’s Head Pet Hospital. I further understand that if payment in full is not rendered at the time of discharge I will be charged interest at the rate of 1% per month on any outstanding balance until such time as the balance is paid in full. Additionally, if the matter has to be placed into collection I will be responsible for all costs of collection including reasonable attorney’s fees.
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What you should know when your pet is hospitalized
  1. Hospitalized patients are examined by the doctor twice daily, or more frequently if indicated.
  2. Visitation- Whenever possible, according to the condition of your pet, is encouraged. Please call to arrange a mutually convenient time.