This form supports telling us about 4 pets in your home. If you have more than 4 pets, please let our office know and we will happily collect information to add them to your account.
Our office accepts Visa, Mastercard, Discover, American Express and CareCredit. We also accept cash and checks.
We cannot offer in-house payment plans for our services. Clients needing additional financial support are encouraged to apply for CareCredit.
Full payment is due at the time of service. Our team is happy to provide any client with an estimate prior to services being rendered. Client will be responsible for a .03% monthly finance charge on accounts over 60 days old. Your signature below indicates your agreement with these policies.
By signing this document, I declare I am the lawful owner of all listed pets and all information is true and correct to the best of my knowledge. I hereby authorize the veterinarian(s) of Apple Country Animal Hospital to examine, prescribe for or treat my pet(s) to the best of their abilities. I assume responsibility for all charges incurred in the care of this animal. I acknowledge that medical information will not be released to anyone not indicated on this form without my express verbal and/or written permission with the except of another veterinary facility.