New Client Information Form

I, THE UNDERSIGNED, DO HEREBY CERTIFY THAT I am the owner, or assuming responsibility,
financial or otherwise, for the animal being presented to Pearland Animal Hospital for treatment or care. I
hereby consent and authorize Pearland Animal Hospital to receive, prescribe for and/or treat my pet as
indicated. It is understood that I assume all risks.

Please let us thank our mutual friend! Who referred you to Pearland Animal Hospital?