Check In & Authorization Form

I authorize Guilford-Jamestown Veterinary Hospital and its staff to treat the above mentioned animal. To administer vaccines, medications, tests, surgical procedures, anesthetics, or treatments that the doctors deem necessary for the health, safety or
well-being of the above animal while it is under their care and supervision.
I am responsible for the payment of the above procedures and treatments in full at the time the animal is discharged. If
I neglect to pick the animal up within five (5) days of the written notice that it is ready for release, you may assume it abandoned. You are then authorized to dispose of it as you see fit. Abandonment does not release me of my obligation for the bill. I agree that in non-payment a finance charge will be charged and that any collection of fees or attorney fees will be paid by me.
By submitting this form, I agree to the above.