By checking this box - I hereby authorize the rehabilitation therapists at Diley's Animal Wellness Group dba DAWG Rehab to examine, prescribe for, and treat the above-described pet(s). I agree to pay for all services rendered and medications, goods, and supplies when purchased. Estimates for any and all recommended treatment can be available to you upon your request. By checking this box, I hereby agree to all of the above and acknowledge the receipt of a copy of this agreement (upon request).