Regional Institute for Veterinary Emergencies & Referrals
2132 Amnicola Hwy
Chattanooga, TN 37406
Phone : 423-698-4612
Fax : 423-622-8145
I/we hereby authorize the veterinarians to examine, prescribe for, or treat my pets (s). I/we assume full responsibility for all
charges incurred in the care of this/these animal(s). I/we also understand that these charges will be paid in full at the time
of release and that a deposit may be required for certain surgical treatments or other procedures.