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.
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, in clinic TV, and any other marketing and/or other social media outlets we may choose to use? *

YesNo
I understand that I will not receive any compensation for the use of these images, and the Clinic may edit and use them with or without my pet's name. I acknowledge that the Clinic owns the rights to the images and may use them indefinitely. While I can revoke my consent in writing, this will not affect any materials already produced. I also release the Clinic from any claims related to the use of these images.*
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 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. Additionally, use of Care Credit requires that the card be present every time and a photo ID that matches the name on the card. We appreciate your understanding 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. Your signature below indicates your agreement with these policies.
Warrenville Grove Animal Hospital uses email, text and our own hospital app for communications regarding our patient's reminders for health care needs. Do we have your permission to contact you via email, text and/or our app regarding these reminders? *

YesNo
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 Warrenville Grove Animal Hospital to examine, prescribe for 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 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, boarding, grooming and or adoption facilities. (unless otherwise noted by you.)
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Client Policies and Procedures