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CLIENT INFORMATION

Preferred Method for Reminders
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May we contact them for your pet(s) records?

PATIENT INFORMATION

authorize the use of my pet’s first name, photograph and clinical information (including medical condition, treatment and prognosis) on MAH’S website, social media, news media page or within informational pamphlets. I hereby authorize Dr. Ledet and the staff of Mandeville Animal Hospital to perform examinations, diagnostics, prescribe for, and treat the above mentioned pet(s). I assume responsibility for all charges incurred for such procedures and treatments. I understand that these charges must be paid at the time services are rendered and a deposit may be required for certain surgical and medical treatments.
authorize the use of my pet’s first name, photograph and clinical information (including medical condition, treatment and prognosis) on MAH’S website, social media, news media page or within informational pamphlets. I hereby authorize Dr. Ledet and the staff of Mandeville Animal Hospital to perform examinations, diagnostics, prescribe for, and treat the above mentioned pet(s). I assume responsibility for all charges incurred for such procedures and treatments. I understand that these charges must be paid at the time services are rendered and a deposit may be required for certain surgical and medical treatments.