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Checks must be from a local bank and you must be a client in good standing. By signing, I authorize the veterinarians at Healthy Acres Veterinary Clinic to render assessment, diagnostics and treatment of my animals as deemed medically necessary. Procedure Estimates: A written estimate of charges is available upon request for services, however estimates are NOT a price guarantee. PAYMENTS ARE DUE WHEN SERVICES ARE RENDERED Signature of Primary CaretakerAnimal InformationSpecies of animals on farm: (select all that apply) Bovine Equine Small ruminant Camelid Swine Other Breeds of animals on farm:Please explain the handling equipment on the farm:Estimated Mileage from Veterinary Clinic at 420 W Wheatland Ave, Remus MI:Services being requested: (Select all that apply) Vaccines Parasite treatment Reproductive services Dental services Wound care Veterinary feed directive Farm visit to establish veterinary relationship Sick animal visit Please explain the symptoms of your animal(s)
