By signing this form, I authorize and approve of any treatment that is deemed necessary by the Veterinarians of Brown Road Animal Clinic in my absence. The maximum this authorization is good for is 1 year.
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I understand I will need to fill out a new form each year if needed.
Owner's Printed Name for E-Signature
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First Name
Last Name
Email
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example@example.com
WItness Printed Name for E-Signature
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First Name
Last Name
Today's Date
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Month
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Day
Year
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