EAST-WEST EQUINE SPORTS MEDICINE, LLC

Duncan F. Peters, DVM, DACVSMR  -  Lori A. Bidwell, DVM, DACVAA, CVA
Brooke Pearson, DVM  -  Madalyn Kalscheur, DVM
P.O. Box 13503, Lexington, KY 40583
(859) 940-4478
office@eastwestequinevet.com

Veterinary Service Agreement

Thank you for retaining East-West Equine Sports Medicine, (LLC) (“East-West”) as your provider of veterinary services. This agreement will govern the veterinary service we provide to the Horse Owner/Lessee (“Owner”) either directly or as approved by an authorized agent listed in this agreement. This agreement applies to all horses owned/leased by Client and applies to any and all veterinary services provided by East-West, including but not limited to, patient services, procedures, treatments, medicines and fees to any and all horses on the Clients behalf, whether or not the horse(s) is listed on this agreement.

Credit Card Information

I understand and agree that all balances will automatically be billed to my credit card at each time of service. Invoices will be emailed. Local Lexington, KY thth clients approved for our Monthly Credit Card Billing Program will have cards charged the 15 and 30 of every month. The signature provided below is a binding contract that guarantees payment of all services and products. Retraction of this authority must be provided in writing to East-West.

CLIENT:

I authorize my Agent(trainer/manager/groom) the responsibility to authorize my credit card, make appointments, approve treatments and procedures, order medications and all other veterinary decisions for all of my horse(s I authorize East-West to release all records/invoices to my Agent. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force, and effect as if I affixed my signature by my own hand.

OR

AGENT:

I have been given authority by my Client/Lessee that, in their absence and through my contractual agreement with my client/lessee, I am responsible to authorize my Client’s credit card, make appointments, approve treatments and procedures, order all medications and all other veterinary decisions for all of my Client/Lessee horse(sI authorize East-West to release all records/invoices to my Client/ Lessee. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force, and effect as if I affixed my signature by my own hand.