New Client Form

I understand that due to a high volume of no show appointments, Advanced Animal Care requires a deposit of $50.00 for new clients on their first scheduled appointment. *

I understand that if I am more than ten minutes late, miss, or cancel my first scheduled appointment without 24 hours notice, my deposit is forfeit and I will need to provide a new deposit to schedule future appointments. *

I hereby authorize the doctor and assistants to administer treatment as is considered therapeutically and/or diagnostically necessary. I authorize medical treatment, as well as possible alternate modes of treatment which are explained to me by the medical staff. Patient confidentiality will be maintained. I authorize images of my pet(s) to be used in social media or for educational purposes. I assume financial responsibility for all charges incurred to the patient. I further understand that if I fail to pay the entire amount, I will be responsible for all attorney's and collection costs incurred for the purpose of collection. I hereby certify that I have read and fully understand the above authorization. Balances due over 30 days will be charged a 1.5% per month interest charge (24% APR) and a monthly billing fee of $5.00. Additional collection fees will be charged if your past due account is sent to collections. *

We do not accept personal checks. We accept CareCredit and Scratchpay, but do not offer payment plans. *

Due to an increase in last minute cancellations and missed appointments, we have instated a new cancellation policy for existing clients. If we do not hear from an established client 10 minutes into their scheduled appointment start time it is considered a missed appointment. We require 24 hour notice for cancellation of an appointment. The first time an established client misses their appointment or cancels without 24 hour notice - It's on us - we all get busy! If an established client has this happen a second time within a 12 month period they will need to prepay for future appointments. This means leaving a deposit of either an examination fee or 50% of their surgical procedure's estimated cost on their account. If a client misses or cancels a prepaid appointment without 24 hour notice their deposit will be forfeit and their deposit will not be refunded. Multiple "no shows" in any 12 month period may result in termination from our practice. *