Online Client Information Form

Payment for service is due at the time services are rendered. The accepted payment methods are cash, credit card (VISA, M/C, AMEX), or Care Credit. If during an exam a written estimate to review costs of diagnostics, and/or medications is desired, one can be prepared upon request. A deposit may be required for new clients, surgery or hospitalization upon admission. We do not accept checks, however, if for some reason a check is accepted a fee in the amount of $36.00 will be charged for any returned checks. A monthly billing fee of $5.00 per month will be charged to all unpaid accounts after the first 30 days.

I agree that should my account become delinquent, I will be responsible for all collection costs, including but not limited to the outstanding balance, attorney fees, court costs, and interest at the rate of 18% per annum (1.5% per month).

Our appointments and procedures require careful planning and scheduling; it is important that clients keep their appointments and arrive 10 minutes before their scheduled appointment time. In this way, we are able to maximize each patient's time with the doctor. We attempt to confirm all appointments by phone, email, or text message but cannot always reach everyone, and ask that you make note of your appointments at the time of booking.

New clients are asked to pay a deposit for the full amount of the office visit charge for the first appointment. This will be held in the client’s account until the date of the appointment. The deposit will be refunded if the appointment is cancelled within 24 hours.

• If a patient is unable to keep an appointment, often another patient on our waiting list could be given that time. Therefore, we kindly ask if you’re unable to keep your appointment, please notify us as soon as possible, even if it is the same day.
• Any client with 2 consecutive late notice cancellations, reschedules or no show will not be offered another appointment unless choosing to pay for the services in advance.
• Any client required to pay for an appointment in advance under the terms of this policy, who does not provide us with 24-hour notice of cancellation regarding the prepaid appointment, agrees to forfeit the deposit/payment.

• PRESCRIPTION MEDICATIONS ARE NON-REFUNDABLE. We are legally unable to accept returns of any prescription medications, including preventatives. If you have any concerns regarding the cost of medications, please let us know prior to checking you out so we may assist you with alternatives.
• APPOINTMENTS ARE RECORDED FOR RECORD KEEPING PURPOSES. Please be aware that we record conversations with our clients during the exam for accuracy in our medical notations. These recordings only occur in the exam room when a doctor or medical staff member is present.
• To prevent the spread of infectious diseases and parasites, hospitalized and boarded patients 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 also understand that if my pet has fleas and requires admission for care, it will be treated at my expense