I understand that payment is due at the time of service. I understand that my card number will be tokenized for my protection, and the actual number will not be stored by Canopy Equine for security purposes.
I authorize that this form is complete in it's entirety and as the owner/agent for the animal(s) listed above, I authorize Canopy Equine Veterinary and Podiatry and their agents to treat this animal as they deem necessary. I assume responsibility for all charges incurred during the care of this animal.(Required)
