Urban Veterinary Assocites 

35 N Cass Ave Westmont, IL 60559

P: 630-541-8088

E: hospital@urbanpetvet.net

Urban Veterinary Associates respects your privacy and will never rent, sell, or share your personal contact information with any outside party.

We may use your email address and/or mobile phone number to communicate important information regarding your pet's care, including:

• Appointment reminders
• Exam, wellness service, and medication reminders
• Messages from our medical team regarding your pet's health
• Promotional offers, coupons, practice news, and announcements (email only)

To avoid excessive communication, promotional emails will be limited to approximately 2–3 messages every six weeks.

You may opt out of promotional communications at any time. However, please note that opting out may prevent you from receiving special offers, discounts, and important practice updates.

I certify that I am 18 years of age or older and that I am the owner of, or an authorized agent for, the pet(s) listed above.

I understand that, except in emergency situations where immediate medical intervention is necessary, recommended treatments and procedures will be discussed with me prior to being performed, and a written treatment plan or estimate will be provided when applicable.

I agree to assume full responsibility for all charges incurred for the care and treatment of my pet(s). In the event that my account is referred for collection, I agree to pay any reasonable collection costs, attorney fees, court costs, and applicable interest associated with the outstanding balance.

I understand that payment in full is due at the time services are rendered. Urban Veterinary Associates does not offer in-house billing or payment plans. We accept the following forms of payment:

• Cash
• Visa
• Mastercard
• Discover
• American Express
• CareCredit
• Scratchpay
• Cherry Payments
• All Pet Card

Checks are accepted only from established clients who have been active with our practice for at least one year and who do not have an outstanding balance on their account.

A valid photo ID is required when paying by credit card, check, CareCredit, Scratchpay, Cherry, or All Pet Card.

By signing below, I acknowledge that I have read, understand, and agree to the terms outlined above.

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Cancellation & Financial Policy

Appointment Cancellation Policy
At Urban Veterinary Associates, our goal is to provide the highest quality medical care for every patient. Each appointment time is reserved specifically for your pet to allow adequate time for discussion, examination, diagnostics, and treatment recommendations.

If you need to cancel or reschedule an appointment, please provide the following notice:

• Monday–Wednesday and Friday appointments: Minimum 24 hours' notice
• Saturday appointments, surgical procedures, and drop-off appointments: Minimum 48 hours' notice
• This advance notice allows us to offer the appointment time to another patient in need of care.

We understand that unexpected situations can arise. If you are unable to keep your appointment, please let us know as soon as possible. Missed appointments or cancellations made without the required notice will be noted in your pet's medical record as a No-Show so we can help ensure appointment availability for all of our patients.

No-Show Fees

All missed appointments ("No-Shows") will incur a non-refundable cancellation fee per patient, due immediately.
All missed anesthetic or surgical procedures will incur a non-refundable fee of $100 per hour reserved, due immediately.

Late Arrival Policy
We make every effort to remain on schedule and respect the time of all our clients and patients. When a patient arrives late, it can impact the care and appointment times of others throughout the day.

• Patients arriving more than 10 minutes late may be charged a late fee.
• Patients arriving more than 15 minutes late may be required to reschedule their appointment and will incur a cancellation fee.
• We appreciate your understanding as we strive to provide quality care to every patient.

Surgical Admissions
All surgery patients must be admitted by 9:00 AM on the day of their procedure.

Patients arriving after 9:00 AM for a scheduled surgical procedure will be required to reschedule. A non-refundable cancellation fee of $100 per hour reserved will be applied to the account.

Financial Policy
Payment is due in full at the time services are rendered.

Prior to treatment, you will receive a treatment plan outlining the recommended services and an estimated cost range. A deposit may be required for hospitalized or inpatient treatments.

Accepted Forms of Payment
Cash
Personal Checks
Checks are accepted only from established clients who:

• Have been clients of the practice for at least one (1) year,
• Have no outstanding balance on their account.
• A valid government-issued photo ID (driver's license or state-issued ID) is required when paying by check.

Returned checks due to insufficient funds (NSF) will:

• Be subject to an additional fee added to the account balance.
• Require immediate payment of all outstanding balances.
• Result in the client no longer being eligible to pay by check at Urban Veterinary Associates.

Major Credit Cards
Visa
MasterCard
American Express
Discover
Healthcare Financing Options

We proudly accept:

• CareCredit
• Scratchpay
• All Pet Card
• Cherry Payment Plans

Special Payment Arrangements
In rare circumstances or emergency situations where no other payment options are available, management may authorize a payment arrangement.

All payment arrangements must be approved before services are rendered and may require:

• A deposit
• A completed financial application
• Full name, address, and telephone number
• Driver's license information
• Social Security number
• Repayment terms will be determined and agreed upon at the time the arrangement is made.

Additional services may be withheld until outstanding balances have been paid according to the agreed terms.

Delinquent Accounts
Accounts with unpaid balances exceeding 30 days may be referred to a collections agency for recovery.

Clients may be responsible for:

• Collection costs and fees
• Credit reporting associated with delinquent accounts
• Any additional costs incurred in the recovery of unpaid balances

Thank you for allowing Urban Veterinary Associates to care for your pet. Your cooperation with these policies helps us continue providing exceptional veterinary care to all patients.

I understand the policies listed above: 

• Cancellation Policy
• Late Policy 
• Financial Policy

AI Recording Consent
To help us provide the best possible care for your pet, Urban Veterinary Associates may use an AI-powered medical scribe during appointments. This technology securely records and summarizes conversations between you and our veterinary team to improve the accuracy and efficiency of medical documentation.

Your consent is required for us to use this recording technology during your visit.

By signing below, you acknowledge and agree to the following:

1. Appointment Recording
   Your appointment may be audio recorded for the purpose of creating accurate medical records. If you prefer not to have your appointment recorded, please let a member of our team know before your visit begins.
2. Use of Recordings
   Recordings and information shared during your appointment will be used solely to assist with clinical documentation and patient care. Any information collected will be handled in accordance with applicable privacy and confidentiality standards.
3. Acknowledgment and Consent
   You confirm that you are at least eighteen (18) years of age and authorized to provide consent for your pet's care. By signing below, you acknowledge that you have read, understand, and agree to the terms outlined above.

We are committed to making every visit comfortable while providing exceptional care for you and your pet.

We love celebrating our patients and sharing their stories with our community. With your permission, Urban Veterinary Associates may photograph or record your pet for use in our educational, promotional, and marketing materials, including our website, social media platforms, print materials, and other communications.

By providing your consent, you acknowledge and agree to the following:

• You grant Urban Veterinary Associates permission to use photographs, videos, and other media featuring your pet for promotional, educational, and marketing purposes.
• Participation is completely voluntary, and you may decline without affecting your pet's care or services.
• You understand that images or videos shared publicly may be viewed by others and may be used across various media platforms controlled by Urban Veterinary Associates.
• You understand that no financial compensation, royalties, or ownership rights will be provided in connection with the use of these images or recordings.
• You release and hold harmless Urban Veterinary Associates, its employees, representatives, and authorized partners from claims related to the use of approved photographs, videos, or recordings of your pet as described above.