Dual Aborn Client Registration Form

1. Treatment – I hereby authorize Aborn Pet Hospital to administer suchtreatment, surgery and additional procedures as necessary on the basis of the findings during examination.

2. Payment – The undersigned agrees whether he/she signs as owner or agent, that in consideration ofthe services rendered to the above patient, he/she obligates himself/herself to pay all fees incurred at the time the patient is released. The undersigned certifies he/she has read and understands the preceding and has had a full explanation of all treatment and fees, as well as all risks associated with such treatments, anesthetics, and surgeries. The undersigned certifies he/she is eighteen (18) years of age and that he/she is the owner and/or owner’s agent of the above animal and is duly authorized to execute the above and accept its terms.

3. Discharge – I shall remove the patient from Aborn Pet Hospital within the three (3) days after beingnotified the patient is to be discharged. If not removed within three (3) days, the undersigned relinquishes all claim to the patient and the hospital shall be free to make whatever disposition of the patient it deems appropriate. Notice to remove the patient may be given in person, by telephone, or by mail to the undersigned owner or agent.

4. All sales are final. No returns.

5. No personnel on premises after clinic hours.