3 Andover Road Glenmoore, PA 19343
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I/we hereby authorize the veterinarians to examine, prescribe for, or treat my pets (s). I/we assume full responsibility for all
charges incurred in the care of this/these animal(s). I/we also understand that these charges will be paid in full at the time
of release and that a deposit may be required for certain surgical treatments or other procedures.
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