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Male or Female:

Authorization:

I hereby authorize the veterinarian to examine, prescribe for, or treat the above described pet. I assume responsibility for all charges incurred in the care of my animal. I also understand that all professional fees are due at the time services are rendered.

I authorize that pictures may be taken of my pet during their visit and are the property of Animal Medical Center and may be used for medical documentation and advertising purposes.

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Animal Medical Center of Mt. Pleasant

958 Houston Northcutt Blvd. Mount Pleasant, SC 29464