• MVC New Client Paperwork

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  • Pet Information

  • Authorization

    I hereby authorize the veterinarian to examine, prescribe for or treat the above described pet. I assume responsibility for all charges incurred in the care of the animal. I also understand that ALL PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. Maurice Veterinary Clinic does not accept checks for small animal services.
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  • THE FINANCIAL POLICY OF THE MAURICE VETERINARY CLINIC

  • Thank you for choosing Maurice Veterinary Clinic. Our primary mission is to deliver the best and most compassionate veterinary care available to your pet. Furthermore, we are committed in making the cost of optimal care as easy and manageable for our clients as possible by offering several payment options. Maurice Veterinary Clinic requires payment in full at the end of your pet’s visit and/or at time of discharge. We only ask that you understand your responsibility and for the payment of your account balance.

    Our basic financial policy is the following:

  • FULL PAYMENT IS DUE AT THE TIME OF SERVICE

    • WE ACCEPT CASH, MONEY ORDER, VISA/MASTERCARD, AMERICAN EXPRESS orDISCOVER

    CARE CREDIT OFFERS CONVIENIENT MONTHLY PAYMENTS ALLOW YOU TO BEGIN TREATMENT TODAY AND PAY OVER TIME AVAILABLE FOR ANY TREATMENT AMOUNT CAN BE USED REPEATEDLY FOR YOUR ENTIRE FAMILY WITHOUT REAPPLYING IF YOU HAVE PET INSURANCE, WE ARE HAPPY TO PROVIDE YOU WITH THE NECESSARY DOCUMENTATION FOR YOU TO SUBMIT A CLAIM TO YOUR INSURANCE COMPANY. BUT IN NO WAY ARE WE RESPONSIBLE FOR YOUR AGREEMENT WITH THE INSURANCE PROVIDER.

    Missed or cancelled appointments without 24 hours will carry a $35.00 service fee.

    For some treatments or hospitalized care, a 50% deposit may be required. Healthcare plans requiring comprehensive care of more than $500.00 will require a 50% deposit to begin your pet’s treatment.

  • YOUR OBLIGATION

  • All customers are responsible for full payment at the time of service. You are responsible for payment regardless even if a final bill is not completed at time of your visit.

  • CLIENT RESPONSIBLTY AND ADDITIONAL TERMS

  • Accounts unpaid after 45 days from day of service are subject to a delinquent fee of $35.00. Furthermore the unpaid balance is subject to a 1 ½% monthly (18% Annual) finance charge. If we have to submit your unpaid account to a collections process you will be responsible for all charges our practice incurs; including late fees, finance fees, collection cost, staff costs, court filing fees and reasonable attorney’s fees. Any returned checks or credit card payments will carry a $35.00 service charge.

    Thank you for understanding our Financial Policy. Please let us know if you have any questions or concerns. If you have any question about our Financial Policy please consult our office staff before signing.

    I have read the Financial Policy. I understand and agree to the terms of Maurice Veterinary Clinic. A picture ID is also required with

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