Phone Authorization

I authorize a South Mesa Veterinary Hospital representative to discuss my semen storage account with me over the telephone. I understand that South Mesa Veterinary Hospital may record this conversation if South Mesa Veterinary Hospital so chooses. I understand I will be asked my social security number and/or my mother’s maiden name for verification purposes.

For Verification Purposes Only

OR
Check this box to acknowledge phone authorization will remain in effect until cancelled, in writing, by the owner.
Check this box to acknowledge email authorization will remain in effect until cancelled, in writing, by the owner.