FMC- 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.FelineMedCenter.com and any other marketing and/or other social media outlets we may choose to use? No identifying information will be used. *

Yes No
I agree to release The Feline Medical Center 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) *
Initial
The Feline Medical Center uses email, text and calls for communications regarding our patient's reminders for health care needs. Do we have your permission to contact you via email, text and/or calls regarding these reminders? *

Yes No (Note: Reminders will not be provided)
The Feline Medical Center no longer provides reminders for appointments or services due by mail. If you choose not to be contacted by email, text and/or phone call, we cannot guarantee timely reminders regarding your pet(s) health. If choosing not to provide permission to contact you digitally, please initial below indicating that you understand the above and release The Feline Medical Center from any liability surrounding notification (timely or otherwise) regarding your pet(s) health care needs. *
Initial
FINANCIAL POLICY:

Our office accepts Visa, Mastercard, Discover, and American Express. We also accept cash and checks (only with verification of valid drivers license or other ID at time of payment).

In addition, we also offer several 3rd party financing options for our clients via Care Credit. We accept a variety of Care Credit plans based on the total transaction amount for your pet. Care Credit requires that payment only be made for services as they are rendered, we cannot charge services to your account in advance. Therefore, Care Credit cannot be used for PAW plan services. We appreciate your understanding of our desire to protect your account/identity.

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.

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 90 days and any collection and/or legal fees on accounts over 90 days. Your signature below indicates your agreement with these policies.
TREATMENT CONSENT:

By signing this document, I declare I am the lawful owner of all listed pets and all information is true and correct to the best of my knowledge. I hereby authorize the veterinarian(s) of The Feline Medical Center to examine, prescribe for and/or treat my pet(s) to the best of their abilities. I assume responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment or hospitalization. I acknowledge that medical information will not be released to anyone not indicated on this form without my express verbal and/or written permission with the exception of another veterinary facility.
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Client Policies and Procedures