• New Client Form

    To update our records please complete the following form:
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  • Name of Employer:

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  • Co-Owner/Spouse Employer

  • Name of anyone else authorized to order treatment or obtain patient information:

  • Estimates and Payment

    We will gladly prepare a written estimate of service fees, if you desire (please ask your doctor).

    All professional fees are due at the time that services are rendered.

    We accept Cash, Visa, Mastercard, Discover, American Express, Care Credit and Scratch Pay.  We NO longer accept personal checks.  Returned checks are subject to a $35 returned check fee. 

    In the case of extensive medical or surgical procedures, we do require a deposit.  We offer Care Credit and Scratch Pay financing for qualified clients.  Please ask a receptionist for details. 

    All balances are subject to a monthly finance charge.  If it becomes necessary to send your account to a collection agency, you are responsible for all collection fees incurred.

    To prevent the spread of infectious diseases, all hospitalized patients must be current on vaccines and free from internal and external parasites.  The signature below authorizes this level of preventative care and also consents to adding any necessary service charges to client invoice to achieve this level of preventative care.  

     

    I HAVE READ THE PREVIOUS STATEMENT AND AGREE TO THE TERMS STATED:

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  • To learn more about our Pet Annual Wellness Plans (PAW Plans), visit our website.  Click the "Begin Enrollment" button, to start your enrollment prior to your pet's appointment. https://www.brightoneggert.com/services/paw-plans.  

     

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