**If you wish to authorize anyone else to use your account, please list their name(s) below. PLEASE NOTE - anyone listed in this section will have full access to your pets’ records & will be allowed to purchase items & request any services for your pets. As the primary account holder, you assume financial liability for actions taken by anyone listed as an authorized user. Authorized users MUST be 18 years of age or older and able to answer questions on your behalf. LVH is unable to set varying levels of authority, so if you do not grant FULL access, do not list those persons in this list.

If you wish to receive updates on LVH events, promotions, etc. via Twitter, Facebook, & other electronic media, visit our website at www.libertyvet.net.

• Payment is expected in full at the time the service is rendered or upon pet’s release. If you have an existing balance, that balance should be paid as well during your current visit. Your pet’s release may be delayed until payment in full is made. Owner are responsible for boarding charges if necessary until debt is paid in full.

• For your convenience, we accept cash, debit cards, Visa, MasterCard, Discover, American Express, & Care Credit.

• We do offer certain discounts such as Golden Buckeye, Pets For Patriots, professional breeders/rescues, & military members. ID may be required. Please inquire with our staff prior to services being rendered if you might qualify.

• Special order products must be paid for in full prior to ordering.  S/O items may not be returnable depending on vendor.

• Your personal information is kept strictly confidential and is not provided to any outside person or company unless at your request, or if your account is delinquent and must be sent to collections.

• A deposit equal to the low end of the estimate may be required prior to treatment for some hospitalization, emergency, dental, & surgery cases.

• Since we strive to make our services available as quickly as possible to all clients, we require sufficient notice for cancellations & rescheduling so we may offer vacated slots to other clients.

• Exams should be changed by 8am the day of the appointment.
• Surgeries & dentals must be canceled/changed by 8am the business day prior to the service.
• We charge for appointments which are missed or canceled without such notice. 
• Late arrivals may need to be rescheduled as a courtesy to other waiting clients.
• If a client has multiple no shows and/or late cancelations, they will be required to pay a non-refundable deposit when making future appointments. If such appointments are missed, the deposit will be forfeited.
• Payment plans are available using Care Credit. Separate and/or prior transactions cannot be combined. Let us know before treatment is rendered if you expect to need such a plan. Please ask us for more details.

Overdue Accounts:

• Account balances more than 30 days overdue will be assessed a 5% service charge per month.
• Account balances more than 60 days overdue will be submitted for collections.

Release:

I grant Liberty Veterinary Hospital (LVH) full permission to use any and all communications from my family, and images of me or my pets for the purposes of education, advertising and promotion, whether taken by LVH staff, or submitted to LVH. This may include (but not limited to) thank you notes, emails, LVH website, on-site displays, Facebook, Twitter, YouTube, etc.  I certify that I am 18 years of age or older, and legally allowed to make such an agreement.

I further agree that LVH may contact me by any mode of communication which I have provided to them, either in writing or verbally. This may include (but not limited to) reminders for your pet’s health services, promotional emails, text messages, etc. Clients may opt out of promotional offers at any time.

I understand that Liberty Veterinary Hospital (LVH) performs its services in good faith, and I accept the payment terms & conditions of the hospital.  I further agree to accept full financial responsibility for all services rendered by LVH & agree to make payment in full upon completion of these services or release of my pet(s) from the hospital.