Caring Animal Hospital Client Agreement Form
AGREEMENT INFORMATION
The information provided in this agreement will help Caring Animal Hospital better serve the needs of my animal(s) and myself. This agreement is between myself, my animal’s co-owner(s) or authorized person(s), and Caring Animal Hospital.
EXPECTATIONS OF CARING ANIMAL HOSPITAL
Veterinary services will be provided by Caring Animal Hospital for animal(s) presented for care. Caring Animal Hospital cannot professionally or ethically provide guarantees on the outcome of any service. Caring Animal Hospital operates under the Veterinarian’s Oath and the limitations of state and national law. Caring Animal Hospital maintains a professionally trained staff and a high level of patient care.
EXPECTATIONS OF CLIENT
I/we will submit all information about the animal(s) truthfully and willfully to Caring Animal Hospital and its staff. I/we will be responsible for maintaining routine vaccinations and providing the proper diet, water, exercise, and shelter my animal(s) needs. I/we understand the financial agreement, no-show policy, standard media release, behavior expected, and standard of care expected while seeking services at Caring Animal Hospital.
FINANCIAL AGREEMENT
- I/we agree to pay for services rendered at the time they are provided, without exceptions. Caring Animal Hospital accepts Visa, Mastercard, CareCredit, ScratchPay, cash, or check. Discover & American Express may be used for a small fee.
- Caring Animal Hospital will not store any payment information - including credit or debit card number(s).
- I/we guarantee that funds are available at time of service when paying by check.
- In the case of check payment being returned due to not sufficient funds, I/we assume financial responsibility of the original check amount, service fee, and bank’s returned check fee of forty-eight (48) dollars, and I forfeit the ability to pay with check again in the future.
- I/we understand that failure to rectify unpaid invoices due to returned checks may result in collections involvement and/or termination of the veterinarian/client relationship.
NO SHOW & LATE CANCELLATION POLICY
Due to the increased demand and wait times for veterinary services across the country, it has become more challenging for our clients to schedule timely visits. Unfortunately, we have also seen an increase in the number of clients failing to show for scheduled appointments despite reminders. Therefore:
- A one-hundred and five (105) dollar fee will be applied to my account if I/we fail to arrive at the clinic for a scheduled appointment without prior notice.
- A fifteen (15) dollar fee will be applied to my account, if I am more than ten (10) minutes late for a scheduled appointment.
- A two-hundred and ten (210) dollar fee will be applied to my account if I/we miss a surgical procedure or 1-hour appointment. Patients that are fed the morning of surgery causing us to cancel, will have this fee applied as well. We will also require a deposit towards the procedure or exam before it can be rescheduled.
- A one-hundred and five (105) dollar fee will be applied to my account if I/we cancel a dental procedure with less than 7 days’ notice, and the appointment cannot be filled with another patient.
- An advanced payment from prospective new clients will be collected before scheduling their first appointment. A deposit in the amount of an exam, per pet, to be applied to the invoice on the day of the appointment.
- If the prospective new client needs to reschedule the appointment and lets us know during our normal office hours at least 24 hours in advance of the scheduled appointment time, we will reschedule the appointment one time, and the deposit will remain as a credit in the new client’s account.
- The deposit is non-refundable, for any reason.
- If the prospective new client cancels or simply fails to show up for the appointment, the advance payment is forfeited and there will be no refund.
- This policy also applies to established clients who have a history of failing to keep scheduled appointments.
ONLINE PHARMACY WAIVER
I/we acknowledge that if I choose to get my pets prescriptions at a 3rd party pharmacy, I will need to get a written prescription from Caring Animal Hospital. I/we also understand once the written prescription has been provided, Caring Animal Hospital is no longer responsible for any mistakes in the filling of that
prescription. Additionally, it is understood that Caring Animal Hospital and their representatives do
not communicate directly with 3rd party online pharmacies, so any corrections must be handled by
the pet's owner.
STANDARD MEDIA RELEASE
- I/we give permission to Caring Animal Hospital to photograph and/or record the animal(s).
- I/we agree that Caring Animal Hospital may post images and/or recordings of the animal(s) to the Caring Animal Hospital website, Facebook, TikTok, YouTube or Instagram account.
- I/we agree that Caring Animal Hospital may use these images for marketing and/or educational purposes.
- Caring Animal Hospital will not provide any personal information about the pet or owner, beyond pet’s name, on any social media site.
BEHAVIOR EXPECTATIONS
At Caring Animal Hospital, our vision states that we strive to set the precedence for quality and innovative veterinary medicine while providing outstanding client relations. Providing you with a high level of care and service requires mutual respect, cooperation, and kindness. To nurture an inclusive and mentally healthy environment for both clients and staff, we have instituted a code of conduct for all Caring Animal Hospital clients. We respectfully ask the following of our clients:
- Understanding, Empathy, and patience. We are empathetic to our patients and clients and appreciate the same in return. Please understand that our team works with individuals and pets with varying levels of need, and in certain situations may need to prioritize their time accordingly. Our individualized approach to patient care relies heavily on equitable time management for all.
- Verbal abuse, malicious or harmful statements, profanity, or degrading comments directed at any member of our staff or fellow clients.
- Any form of harassment including but not limited to cyberbullying, discriminatory comments and/or actions, and intimidation tactics and/or threats.
- Refusal to pay for products and/or services.
We have a zero-tolerance policy for the following behaviors:
This policy is strictly enforced, and non-compliance will result in corrective measures, up to and including being asked to leave the property, and/or terminating the veterinarian/client relationship.
STANDARD OF CARE
As stated in our vision we strive to set the precedence for quality and innovative veterinary medicine. We treat each patient individually and tailor our recommendations based on your animal(s) needs. We follow the AAHA Vaccine guidelines, Fear Free protocols, and Companion Animal Parasite Council recommendations. We require yearly well exams on all species including exotics. Every patient undergoing anesthesia is required to have recent blood work and is given fluids while under anesthesia. We expect our clients to follow our veterinarian’s recommendations and treatments to ensure the best outcome for the animal(s). If we find that our recommendations are repeatedly declined or not followed, we may ask you to find a veterinarian that would better suit your expectations for care. Animal(s) will not be euthanized without an exam and diagnostics. If the disease process is treatable, we reserve the right to refuse to euthanize the animal, and instead will make recommendations for treatment.
Please understand that the health and well-being of your animal is very important to us, and we wish to offer the best veterinary services for the animal(s). Thank you for choosing Caring Animal Hospital as your healthcare provider.
I acknowledge that I have completely read and fully understand the above and agree to be bound thereby. I understand that failure to comply may result in no longer being able to seek care for the animal(s) in my care at Caring Animal Hospital.
