By submitting this form, I understand that:
· Payment is expected, in full, at the time services are rendered. We do not accept payments or offer any payment plans.
We accept Care Credit, Discover, Master Card, VISA, debit cards, and Cash only.
· I understand that a deposit of 50%of the estimate may be required before services are performed.
· A 1.5% monthly (18% annual) service fee is charged to any account with an unpaid balance.
· It is understood that an estimate of charges will be given for services when requested.
· I assume full financial responsibility for all charges incurred by my pet. I realize that these charges may exceed a given estimate if complications arise. I understand that I will be contacted prior to treatment, if possible, should complications occur.
· In order to keep our costs down it is our policy to pursue all delinquent accounts.
· Should I abandon my pet at this facility, I understand and agree to allow Best Friends Animal Health Center to treat my pet in the event of an emergency. I agree I am responsible for emergency fees that incur during my pet’s stay. I also acknowledge Best Friends Animal Health Center may assume ownership of my pet in 10 days if my pet has been abandoned due to hardship or lack of payment.
· Should my account be turned to collections, for any reason, I authorize Best Friends Animal Health Center to release medical records and all client and patient information to the necessary person(s) tasked to collect this debt. I agree to assume collection costs including, but not limited to, collection agency fees, attorney fees, court costs and/or any other associated fee(s).
· My submission of this form confirms that I have read and understood the above.