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Registration of a Patient

Information of the owner

Information of the animal

Animal species

Contract governing medical treatment

I assure that I am the holder of the animal and authorised to conclude a contract for the execution of necessary treatments and operations, in addition I assure that I am willing and able to pay the resulting costs. In this context, I declare that at the time of this declaration I have not been subject to any judicial debt procedure and that the debtor register of the district court in which I have jurisdiction does not contain any entries concerning my person.

Unless I am the holder of the animal, I assure you to act by order of the owner of the animal. If there is no authorization, or if the pet owner refuse an authorization, I certified herewith that I will pay for the incurred expenses from the treatment.

As far as it is necessary to diagnose, I authorize the owner and the staff of the practice, third-party services (laboratories, special investigators, etc.) in my name and on my account to claim.

I pay the resulting costs instantly in cash or by EC- Card.

I am aware that the practice has a right of retention on the treated animal if I am not willing or able to pay the costs of treating the animal in cash or by debit card.

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