Veterinary New Client/New Pet Enrollment Form

Client Policies and Procedures

We want you to be aware of and understand the following policies and procedures for all clients.
We Love Social Media! Do we have your permission to post pictures and/or videos of your pet(s), you and your pet(s) and/or your pet(s) and our team on Facebook, Instagram, Twitter, TikTok, www.gauseblvdvet.com and any other marketing and/or other social media outlets we may choose to use? *

YesNo
(Initial Required) If I neglect to pick up my pet within 10 days of the pickup date and fail to make otherarrangements, GBVH assumes that the pet is abandoned and is hereby authorized to take possession of the pet andmake any decisions as may be deemed best and necessary for its care.*
INITIALS
Gause Boulevard Veterinary Hospital uses email, text and our own hospital app for communications regarding our patient's reminders for health care needs. Do we have your permission to contact you via email, text and/or our app regarding these reminders? *

YesNo
FINANCIAL POLICIES

We do not bill. All fees are due at the time that services are rendered. We accept Paypal, Care Credit, Visa, MasterCard, Discover, and American Express as well as cash. WE DO NOT ACCEPT CHECKS. As a courtesy we do offer extended payment plans through the following outside sources: Care Credit, Scratch Pay, and PayPal Financing.
I have read and acknowledge the financial policies of Gause Boulevard Veterinary Hospital. (Initials Required)*
INITIALS
I certify that I am 18 years of age or older and I am the person responsible for authorizing and paying for all medical procedures and expenses for the listed pet(s).
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Client Policies and Procedures