I hereby authorize the veterinarians at Churchland Animal Clinic to examine, prescribe for, and treat the above described pet(s). Any animal admitted or hospitalized shall receive the necessary diagnostic test and treatment to ensure proper medical care. I agree to pay for all service rendered and medications, good and supplies when purchased. I understand that a deposit may be required for surgical or medical treatment. All accounts not paid within 30 days will be subject to a late charge of 1.5% per month (18% per annum) on the unpaid balance and billing charges in the amount of $3.00 per month. In the event of default the undersigned further agrees to pay any and all collection agency, court cost and attorney fees in the amount of 33 1/3% of the total due when turned over for collection. These fees are due without any relief whatever from valuation or appraisement laws. This contract extends to all additional pets brought in at a later date. ALL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED. A $35.00 charge is made for all returned checks.
I understand the doctor hours are from 8am-12pm and 2pm-7pm Monday through Thursday and Friday 8am-12pm and 2pm-6pm and Saturday 8am-2pm. I understand that at all other hours there may not be a veterinarian providing continuous care.
By my signature below, I hereby agree to all of the above and acknowledge the receipt of a copy of this agreement (upon request).