We will gladly provide a written treatment plan for any recommended treatments or procedures.
Payment is due at the time of service. We accept all credit/debit cards, personal checks, and CareCredit.
Use of a credit/debit card of any type (aside from Care Credit) will incur a 4% fee per instance.

DUE TO STATE LAW AND INSURANCE REQUIREMENTS, ALL DOGS AND CATS MUST BE CURRENT
ON RABIES VACCINATION WITH PROOF SIGNED BY A LISCENSED DOCTOR OF VETERINARY
MEDICINE. WE WILL SEE YOUR PET SO LONG AS YOU AGREE TO UPDATE VACCINATIONS AT THE
TIME OF YOUR APPOINTMENT.

I understand every effort will be made to achieve a successful outcome and to provide for all possible safety in hospital
care and handling. I hereby authorize this The Pet Clinic to receive, prescribe for, treat, or perform surgery upon the
pet(s) listed and on any additional pets I may present. I agree to pay fees for services rendered at the time the pet is
discharged from the clinic or the service is otherwise terminated. I agree to pay for the reasonable costs of
collection if collection efforts become necessary. I understand that a service fee of $20 will be assessed for each non-sufficient fund checks and/or certified letter that must be sent. I understand that veterinary service is provided during nighttime hours as necessary in the judgment of the veterinarian in charge should my pet be hospitalized.
Continuous presence of qualified personnel will not be provided. If I neglect to pick up my pet within 5 days of the
discharge date and do not notify you within that time, you may assume that said pet is abandoned and are hereby
authorized to dispose of my pet as you deem best.

We have a No-Show Policy regarding appointments. This policy also applies to late arrivals and shortnotice cancellations. We understand that inadvertently missing appointments can sometimes happen; however, we must consider how these missed appointments impact the ability of other patients to make appointments and these missed appointments often delay or prevent other patients from receiving timely care.

To be fair to all our patients, the following policy is in place:

• You must call to cancel an appointment at least 24 hours in advance.
Calling to cancel within an hour of the appointment time will automatically be considered a No-Show.

• Patients arriving more than 10 minutes late to their scheduled appointment will be considered a No-Show. We will make every effort to reschedule but may require a deposit to hold your appointment.

• The second No-Show will result in a No-Show Fee at the amount that would normally be charged for the exam the patient was scheduled. Exam fees range from $46-$70. This payment must be paid before additional services are rendered.

• The third No-Show, within one year of the first, will lead to a letter of dismissal from the practice. All missed appointments are cumulative within a family.

We understand that everyone has emergencies that necessitate missing appointments. Determining No-Show versus acceptable missed appointment will be up to the sole discretion of The Pet Clinic.

Our goal is to accommodate all patients, but a pattern of recurrent missed visits prevents other patients from being seen by their physician in a timely manner. Please feel free to call our office with any questions.

I agree by signing below that I have read and understood this No-Show Policy.