Consent for Veterinary Services

(If more than one horse, I consent that all of my horses brought to De Cillo Equine Clinic may receive Veterinary Services.)

I, as owner of Horse listed above, understand that now, and from time to time in the future, it may become necessary that Veterinary Examination, Treatment or Consultation be provided. In the absence of specific instruction to the contrary, or in the even that I cannot be reachec, I hereby authorize my agent:

My agent may act on my behalf in the arrangement of such services with a licensed Veterinarian. Further, I agree to be responsible for the payment of all fees incurred. I understand that this payment must be made when services are rendered, or in the case of hospitalization, payment must be made weekly until my horse is discharged. I further understand that my entire billing account must be paid in full for my horse to be released to me.

PLEASE BE ADVISED THAT IT IS A REQUIRED SAFETY PROTOCOL AT DE CILLO EQUINE TO SEDATE ALL HORSES FOR ALL DIAGNOSTIC IMAGING INCLUDING BUT NOT LIMITED TO RADIOGRAPHS AND ULTRASOUNDS. THE ATTENDING VETERINARIAN WILL DECIDE THE TYPE AND AMOUNT OF SEDATION REQUIRED. DECILLO EQUINE CLINIC ADMINISTERS THE FOLLOWING SEDATIONS AS NEEDED; XYLAZINE, DORMOSEDAN, BUTORPHANOL, AND ACEPROMAZINE.

DE CILLO EQUINE FINANCIAL POLICY

To reduce confusion and misunderstanding between our dedicated team and loyal clients, we have adopted the following financial policies. If you have any questions regarding these policies, please contact our Office Manager at Accounting@decilloequine.com. We can only provide the best team, state of the art equipment, medication, and care by being paid at the time services are rendered. While circumstances arise from time to time, payment in full is expected at discharge and when the appointment is complete.

 Payment Options

1. Payment is required at time of service:

Full payment is due at the time of service. De Cillo Equine Clinic does not provide payment plans. For your convenience we accept cash, checks, credit cards (i.e.; VISA, Mastercard, Discover and American Express), and Venmo (Venmo is not the same as cash and receives a surcharge). To cover the cost of processing a credit or charge card transaction, credit card payments will include a processing surcharge in an amount not to exceed the cost of processing the charge (charges vary by clients’ credit providers, but most are 3.5%). Surcharges do not apply to cash, debit cards, or checks.

De Cillo Equine Clinic requires a valid credit or debit card to be kept on file for all accounts. After 14 days with no payment on balances, De Cillo Equine Clinic reserves the right to charge said card for balances with fees accrued for any declined payments.

In the event that a check bounces, a $35 fee will be issued for returned checks. Following 2 returned checks from the same client, checks will no longer permitted from said client.

Deposits ($300-$500 for regular urgent care, $1,000+ for specialty procedures/etc.) may be required for same day urgent or emergent services, as well as new account appointment booking. We require purchases of medication and Routine Vaccinations, Coggins, and Health Certificates be paid in advance.

2. Care Credit or Scratchpay

Care Credit and Scratchpay offer clients financing options. De Cillo Equine Clinic accepts both of these lenders. Both are subject to surcharges based on financing options.

3. Insurance

Clients that have insurance will pay at time of service, then submit the invoices to their provider. De Cillo Equine Clinic will not extend terms on insured animals.

4. Interest Charge on Late Payments

Any account balance over 15 days past due will be assessed a 10% Interest Fee. The fee is calculated at 10% of total balance due including fees and interest. Any account that is over 15 days with no minimum payment will incur interest at a rate of 10% monthly.
De Cillo Equine Clinic reserves the right to refuse service to any client who has an overdue account balance.

*De Cillo Equine Clinic reserves the right to keep an animal in hospital at the cost of the client until the client’s bill is paid in full. If a client refuses to pay, De Cillo Equine Clinic will accept relinquishment of the animal to the care of the business, De Cillo Equine Clinic, PLLC. De Cillo Equine Clinic reserves the right to refuse service to any client with a history of late or incomplete payment.

De Cillo Equine Clinic wants to stay in touch with you regarding your account. In order for us to service your account or to collect any amounts you may owe, we may contact you by telephone at any telephone number, including wireless telephone numbers that you have or may attain, which could result in charges to you. We may also contact you by sending text messages to any telephone numbers that you have or may attain, or e-mail using any e-mail address on your account. Methods of contact may include using pre-recorded/artificial voice messages and/or use of an automatic dialing device, as applicable. De Cillo Equine Clinic sends discharge and financial paperwork via email so a valid email is required when setting up an account.