Due to Kentucky identification laws, we will need a copy of your driver’s license on file, if you plan on paying with any form other than cash each time you visit LCAC. If we do not have a copy on file you will not be allowed to use any other payment method until we have received this information.

PAYMENT IS DUE IN FULL AT THE TIME SERVICES ARE RENDERED

I understand that if I do not pay as agreed, the account is subject to costs of collection, attorney fees, and including interest (any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% per annum). Any unpaid balances will result in legal actions which you are responsible for. Return check fee is 50.00. I understand that the hospital staff will provide an estimate of current and anticipated charges any time that I request one. I am requesting that veterinary care be provided for pets presented by me or my agents, including any pets cared for in the future. I understand that I am financially responsible for all services provided; a deposit may be required to initiate treatment.

I also grant LCAC and its representatives and employees the right to take photographs / videos of me and/or my pet, and to copyright, use and publish the same in print and/or electronically. Such photographs / videos of me and/or my pet with or without my name and for any lawful purpose, including, for example, such purposes as publicity, illustration, advertising, and Web content including social media.