Financial Policy

Please choose one of the following payment options and sign/date below.

STATEMENT DISCLOSURES AND FINANCE CHARGES
Any unpaid balance will be subject to a service charge of 1.5% per month (APR 18%). The minimum service charge is $4.50 per month. This service charge is calculated and assessed on the 25th day of each month. If payment is over 30 days or is made by check with insufficient funds, the client will lose any discounts and/or billing privileges give nat the time of the original purchases of supplies or service. The client is responsible for payment of all charges within the limits of our financial policy, regardless of insurance coverage or dispute between an owner, stable, or trainer.

RETURNED CHECKS
A $35 service charge will be assessed for any check returned for non-sufficient funds.

Please review YOUR BILLING RIGHTS per Federal Fair Credit Billing Act terms and conditions below.

Name

First Name

Last Name

Email

CHOOSE YOUR PREFERRED PAYMENT OPTION

Please choose option 1 or option 2 below.

1. PAYMENT IN FULL at the time of veterinary services, medications or supplies provided.

Cash, Visa, MasterCard, Discover Card, American Express, and Care Credit are accepted forms of payment. Client or authorized person must be present at the time of service to render payment.

Select Option 1

2. AUTO-BILLING with Credit Card on file.

Each invoice will be applied to your credit card. Your invoice will be emailed to you on the day of the payment transaction. Please fill out the Credit Card Authorization form to have your card on file.

Select Option 2

AUTHORIZATION FOR PAYMENT OPTION

All policy terms and conditions are outlined on this page. Please provide your electronic signature below.

Electronic Signature

I agree that I have read and understand the authorizations and policies outlined and by checking the box below, I agree to these authorizations and policies.

Yes, this is my electronic signature.

Date

MM

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YOUR BILLING RIGHTS
This notice contains important information about your rights and our responsibilities under the Federal Fair Credit Billing Act. NOTIFY US IMMEDIATELY IN CASE OF ERRORS OR QUESTIONS ABOUT YOUR BILL. You may telephone our office, but doing so will not preserve your rights. Formal disputes must be in writing. We must hear from you no later than 60 days after receiving your first statement of charges on which the error or problem appeared. In your letter, give us the following information:
• Your name and account number
• The dollar amount of the suspected error
• Description of the error and explanation of why you believe there is an error
You remain obligated to continue to pay on the parts of your statement that are correct. You do not have to pay any amount in dispute during the time our accounting department is resolving the matter. During this time, we may not take any action to collect disputed amounts or report disputed amounts as delinquent.

Please choose one of the following payment options and sign/date below.

Our daily mission is to listen, to care, to help, and to heal.

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