2025 Client Information

2025 Client Information
As we welcome the new year, we aim to provide you with the best possible service and ensure seamless communication. To achieve this, we kindly ask you to confirm and update the contact information we have on file. Additionally, we want to take this opportunity to share some updates regarding our internal procedures so you know what to expect from us moving forward.

We value your partnership and appreciate your time in helping us maintain accurate records and clear communication. Please take a moment to complete the attached form.

Thank you for your continued trust in us, and we look forward to serving you in the year ahead.

Name*

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Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Drivers License Number:*
Date of birth:*
Additional Parties with permission to make medical and financial decisions:
Phone Number
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All our patients are super stars! We would love to have permission to take their picture for our medical records and our social media pages. Do you give us permission to take a photo of your pet(s)?*

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Please check out our website at mycountylinevet.com and our socials at

mycountylinevet.com

facebook.com/CountyLineVetClinic

instagram.com/mycountylinevet

Financial Policy

Thank you for choosing County Line Veterinary Clinic. Our primary mission is to deliver the best and most comprehensive veterinary care available for your pet. An important part of the mission is making the cost of optimal care as easy and manageable for our clients as possible by offering several payment options. County Line Veterinary Clinic requires payment in full at the end of your pet's examination and/or at the time of discharge. *Payment policy- All payment is due upon completion of services rendered. Any balance that becomes 30 days past due may incur a finance charge of 15% per month.. If you have any problems paying your bill as described, please contact or office for further assistance.
Initials*
Payment Options:

You can choose from:

-Cash or Check are preferred methods of payment. Paying by cash allows CLVC to keep costs low.

-Visa®, MasterCard®, American Express® or Discover Card® are accepted

-Convenient Monthly Payment Plans¹ from VetBilling and CareCredit® subject to credit approval.
Initials*
We are a privately owned, family-oriented practice and do our best to be available for our current patients. To help as many pets as possible and due to an increase in no-show appointments, we require a booking fee of $69 for new clients or any clients with a previous history of no-show, cancellation within 24 hours or delinquent payments. We understand things come up and schedules change but if you are unable to keep your appointment with us, you must cancel (via email or text is recommended) within 24 hours of your appointment and 72 hours of your surgical procedure or your booking fee is NON-REFUNDABLE. This allows us to help another patient during that appointment time

Current clients in good standing will not be required to pay a booking fee in advance, however if a late cancellation or no-show appointment occurs County Line reserves the right to require a booking fee for future appointments.

For all surgical procedures a $150 booking fee is required. Some treatments/hospitalized care or services provided by an outside service provider; a 100% booking fee is required. Healthcare plans requiring comprehensive care of $100 or more, may require a 50% deposit to begin your pet's treatment.

County Line Veterinary Clinic charges $50 for returned checks.

For clients with pet insurance, we are happy to provide you with the necessary documentation to submit a claim to your insurance carrier.
Initials*

Client and Veterinary Relationship Guidelines

A Veterinary Client Patient Relationship (VCPR) is required for our veterinarians to order lab work, prescribe or refill medications and provide advice on a patient’s health status or care. In veterinary medicine, a strong Client-Patient-Veterinarian Relationship (CPVR) is crucial. It's founded on mutual trust, open communication, and shared decision-making between the veterinarian, the client, and the animal patient. To maintain VCPR, a patient must be seen at least every 12 months by our veterinarian(s) for a wellness visit.

·         Our team is dedicated to providing gold-standard recommendations for your pet's care, along with the necessary education to empower you in making informed decisions.

·         We understand that every pet and family is unique. We encourage open communication regarding your family's values, treatment capabilities, and financial limitations. This open dialogue allows us to tailor our recommendations to best suit your pet's needs and your family's circumstances.

·         So that we may review your pet’s medical history and provide them with the best care possible we ask that you schedule an appointment for each pet you wish to discuss with the veterinarian. This allows our clinic to run on time for other appointments and the doctor’s to accurately and completely document the pet’s visit.

Open and respectful communication is a keystone to providing exceptional care for your pet. Our promise to you, our team will communicate your pet’s condition, recommendations, lab results, prognosis and diagnosis in a timely, clear, respectful and professional manner. While we understand many visits to the vet are stressful, we ask that interactions with our staff remain professional and non-threatening.

Trust is equally important to our ability to care for your pet. If at any time you have a concern or feel the trust between County Line and yourself has been damaged, we ask that you notify the Veterinarian or Practice Manager so we may address the concern. At no time is a second opinion or referral considered a breech of trust; we desire to work with other veterinary professionals for the best care of your pet.

To keep costs as low as possible for our clients, we keep the most used medications in stock. Some medications are deemed special order and therefore require more time to complete a refill. We request you give us 5 to 7 business days to refill any medication in case it must be special ordered. Occasionally we will recommend ordering chronic medications via our online pharmacy if it is less expensive for you long term.

Keeping clients updated about their pet’s vaccine and lab work due dates is important to us, to do this we use our app and automated text messaging through a third-party Vet2Pet. If you do not wish to have access to the app and text messaging, please let our receptionist know and we can remove access via our portal. If you are interested in the app, you may find it on the app store.

We have Wellness Plans! This allows our clients to spread out the cost of their pet’s wellness needs over 12 months. Please let a technician know if you are interested and they can provide more information.

You are entitled to a complete and thorough copy of your pet’s medical records at any time, including transferring them to a third party for adoption of new pets, housing verification, or scheduling of boarding, daycare, training, or veterinary specialist appointments. Medical records will be transferred by your request within seven business days. Record transfers may only be made by the listed agent(s) on the account. Upon termination of the VCPR, we will transfer your pets’ records to the email on file.
By signing below, you acknowledge receipt of and agree to the County Line Veterinary Clinic’s Client Information and Policies, including the Financial Policy, Client and Veterinary Relationship Guidelines, and Pet Medication Policy
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