Declaration
I undertake to pay all costs incurred in this procedure. I agree to your trading terms of payment at the time of discharge (unless other terms have been arranged prior to surgery). If a delayed payment plan is negotiated, I agree to pay all outstanding costs associated with any account within 7 days. I agree that I will be liable for all costs associated with the recovery of any outstanding invoices. Such costs may include an overdue account fee, all Debt Collection at the agreed rate of 28% plus GST, and Legal Costs at the rate charged by the Legal Practitioner or Court.
I agree to indemnify the attending veterinarian, their servants and agents for any loss or liability that they may incur as a result of any inaccurate information provided on this consent form, whether intended or otherwise.