Authorization
I am the owner of the above animal or am responsible for it, am 18 years of age or older, and have theauthority to execute this consent.
- I hereby authorize treatments of this animal and performance of such surgical or therapeutic procedures as Highland Animal Clinic determine to be indicated and the use of such anesthetics as they deemadvisable and necessary.
- It is also agreed that I am responsible for this animal and that payment in full is due at the time of discharge, and that any treatment plan/estimate of $1000 or more will require a $500 deposit at check-in.
- I realize that accounts over 30 days old are considered past due and are subject to an administrative fee($6.00 or 1.5%, whichever is greater) on the 31st day, and on each 30 days past that. In addition, the costs of collection, including reasonable attorney's fees, will be paid by the undersigned.
- The person listed above as "Co-Owner" shall be an authorized signer for this patient and has my consent to make any and all health care decisions for my pet. However, as the primary owner/signer, I agree to be ultimately responsible for payment on all authorized services.
- If I neglect to pick up the animal within five days of written notice, sent to the above address, my pet will be considered abandoned. In cases of abandonment, Highland Animal Clinic will have authorization to
dispose of the pet as we see fit. Abandonment does not release me from my obligation to pay for all charges involved.
Cancellation Policy:
To ensure that every pet in need is seen we have implemented a 24-hour cancellation policy. Appointments that are missed or canceled with less than 24 hours’ notice will require a deposit to schedule again. If future appointments are missed, the deposit is forfeited. Highland Animal Clinic reserves the right to refuse scheduling future appointments for repeated missed exams.
Highland Animal Clinic accepts: Cash / Local Check / Mastercard / Visa / Care Credit / Scratchpay