New Client Information
Date Format: DD slash MM slash YYYY
- ** All invoices, receipts, exercise recommendations, appointment reminders and other correspondence will be sent by via email, as this attempts to be an entirely green practice.
Your Pet's Information
- *** Please bring your dog’s favorite treat broken into small bits with you.
(ex: Rimadyl 25 mg–1 twice daily) separate by new line.
include: herbs, vitamins, glucosamine, glandulars and homeopathics. Separate by commas.
Consent for Rehab Therapy - RESPONSES REQUIRED
Release Section - RESPONSES REQUIRED
By signing this statement, I signify that I agree and accept these conditions.
Canceled Appointments Policy - RESPONSE REQUIRED
We all have times that problems arise and cause the cancellation of an appointment at the last minute. It happens to everyone. But if it happens more than twice or more than one appointment is missed without notification, the full amount of that appointment will be billed to you. Clients who are more than 10 minutes late may be asked to reschedule. Please, just be considerate.
By initialing, I agree to the cancelled appointment policy above.
Annual Physical Exam
Patients who are treated at Healing Arts Animal Care for over one year will need to have an annual physical exam with us. We need to do this once a year for all of our patients to stay in compliance with state law. The exam can be done at a regular visit and the fee is $50. If you have any concerns about this, feel free to talk to us about it.
By initialing, I agree to annual physical exams and accept these finanical conditions.
Healing Arts Animal Care happily will take cash, check, American Express, Discover, Visa and Mastercard for payments. Payment is always due at the time of service. There is no billing permitted for services. If payment is not received at the time of service there is a 10% per month billing fee, and non-payment is sent to collections at 90 days. There is a $30 returned check fee.
By signing this statement, I signify that I agree and accept these financial conditions.
I understand that by initialing that this constitutes a legal signature confirming that I acknowledge that the above information is true and agree to the above terms and releases of liability.