Client Information Sheet

Pet Owner's Information

Owner's Name(Required)
Address(Required)
How did you first hear about us?

Pet's Information

Sex(Required)
Sex
Photo Consent: Do you authorize McCormick Animal Clinic to use pictures of your pet(s)?

Payment Policy

We accept cash, checks, and all major credit cards in payment of services at the time your pet is discharged. If you are uncertain about the cost of your pet's medical care, you may ask for an estimate of charges prior to treatment.

I fully understand the terms of this agreement. I also understand that any portion that remains unpaid after thirty days is subject to the services of a collection agency. I will be responsible for all costs including any attorney's fees.

I am the owner or authorized agent of the owner of the pet(s) described on this document and give permission for treatment as deemed necessary by the veterinarian.

Consent(Required)