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New Patient Information

Client / Owner Information
Address
About Your First Pet
Marketing
Previous vet to get patient history
City and State

Note: We take pride in the quality of service and medical care we are responsible for providing you and your pet. In an effort to maintain these standards and keep your costs at a reasonable level, we do not bill for services rendered. We accept cash, checks, and credit/debit cards.

I agree to pay for professional services and medications as they are rendered. The information on this form is true and accurate.

FINANCIAL AGREEMENT

  1. All fees due at time of service unless prior arrangements made.

  2. All accounts, 30 days past due, are subject to a finance charge of 1.5% monthly.

  3. After 6 months, past due accounts are turned over to a collection agency and all fees incurred due to collections are the clients responsibility.

I HAVE READ, UNDERSTAND, AND AGREE TO THE FINANCIAL AGREEMENT.

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