Payment for veterinary services is due in full at the time services are rendered unless otherwise agreed in writing. The client remains financially responsible for all charges incurred, including those authorized by a trainer or agent. You also agree to pay all charges incurred during any periods when payment for such charges is pending determination by a third party payer.

For security reasons, credit card information is not collected on this form. Payment information will be provided by telephone prior to the time services are rendered. The client authorizes Bella Vista Equine Veterinary Services to charge the card for approved veterinary services. The client also authorizes the clinic to securely store this credit card on file for future charges associated with my account.

Past-due accounts may be subject to lawful collection efforts. Non-emergency services may be suspended for delinquent accounts.

For emergency services provided to individuals who are not established clients of the practice, an advance deposit or payment may be required prior to the provision of veterinary services. The amount of any required deposit will be determined based on the circumstances of the emergency and the anticipated scope of services.

For purposes of this agreement, an established client is defined as a client who has utilized the practice's non-emergency veterinary services within the preceding calendar year.

Established clients may not be required to provide advance deposits except as otherwise agreed in writing.

Payment in full for all services rendered is due at the time of service unless prior arrangements have been made.

Accepted forms of payment include cash, check, and major credit cards.

Billing disputes must be submitted in writing within a reasonable time after receipt of the invoice. This agreement is governed by Ohio law.

I have read and agree to the terms of this Client Service Agreement.