Veterinary New Client 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 of your pet(s), you and your pet(s) and/or your pet(s) and our team on Facebook, Instagram, Twitter, www.gemcityvet.com and any other marketing and/or other social media outlets we may choose to use?*

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I agree to release Gem City Veterinary Services from all claims for libel, slander, invasion of privacy, infringement and copyright or right of publicity or any other claim and confirm that you are over the age of 18 years old. (initial below)*
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FINANCIAL POLICY:

Our office accepts Visa, Mastercard, Discover, and American Express. We also accept cash and checks.

In addition, we also offer 3rd party financing options for our clients via Care Credit and Scratchpay. Applying is easy and only takes about 30 seconds at carecredit.com or scratchpay.com

As financing options are offered, we cannot offer additional in-house payment plans for our services. Clients needing additional financial support are encouraged to apply for Care Credit with a co-signer. Locally, ACPE FCU offers personal loans for pet care.

Full payment is due at the time of service. This includes any charges/fees agreed to by my authorized proxy. Our team is happy to provide any client with a written treatment plan prior to services being rendered. Client will be responsible for a 1.5% monthly finance charge on accounts over 30 days and any collection and/or legal fees on accounts over 90 days. Your signature below indicates your agreement with these policies.
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Welcome To Our Practice

Client Policies and Procedures