• Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
  • OR

    If you would like another person to be able to make decisions regarding your pet, please provide contact information:
  • NAH will use all reasonable precautions against injury, escape, or death of my pet. The clinic and staff will NOT be held liable for any problems that develop provided reasonable care and precautions are followed. I understand ANY problem that develops with my pet while I’m absent will be treated as deemed best by the veterinarians, and I ASSUME FULL RESPONSIBILITY for any of the treatment expenses involved. I understand that if FLEAS ARE FOUND ON MY PET HE/SHE WILL BE TREATED WITH A CAPSTAR TABLET.
  • Date Format: MM slash DD slash YYYY