New Client Form

 

Pet 1
PET 2
We will gladly prepare a formal estimate if you desire. Please ask a Patient Care Coordinator should you choose to request one. FULL PAYMENT IS DUE AT THE TIME SERVICES ARE RENDERED. A deposit may be required for surgery or hospitalization upon admittance. A billing charge of 1.5% per month (18% per annum) will be charged on all accounts after the first thirty (30) days. ANY CHECKS RETURNED FOR INSUFFICIENT FUNDS, ETC., WILL HAVE A $25.00 FEE APPLIED. To prevent the spread of infectious diseases and parasites, hospitalized and boarded animals must be current on all vaccines and free of internal and external parasites. I authorize the doctor to provide vaccines and parasite control as needed for my pet. I, the undersigned, assume financial responsibility for all charges incurred, and agree to pay all such charges at the time services are rendered or as arranged prior to examination and/or treatment.
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