ALL ANIMALS COMING INTO THE HOSPITAL MUST HAVE A CURRENT RABIES VACCINE. IF PROOF IS NOT PROVIDED A THE TIME OF THE VISIT, A RABIES VACCINE WILL BE GIVEN AT YOUR EXPENSE.
TO HELP PREVENT THE SPREAD OF INFECTIOUS DISEASE, ALL HOSPITALIZED, BOARDING, AND DROP-OFF ANIMALS MUST BE CURRENT ON ALL VACCINATIONS AND FLEA-FREE.
BY SIGNING THIS DOCUMENT, I ATTEST THAT I HAVE READ AND AGREE TO THE AFOREMENTIONED CONDITIONS.

Pet Information

FINANCIAL RESPONSIBILITY/ POSSESSORY LIEN

Stone Ridge Veterinary Medical Center I understand that I assume nancial responsibility for all services rendered. I further agree to pick up my pet at the designated time and to pay in full for all services rendered. I also understand that my pet will not be released until the balance is paid in full. If my pet is not picked up as agreed, a written notice of abandonment will be mailed to me. Twelve days after the notice is issued, my pet will be considered abandoned and may be disposed of in a manner deemed appropriate by Stone Ridge Veterinary Medical Center. By signing this document, I attest that I have read and agree to the aforementioned conditions.

TREATMENT AUTHORIZATION

I understand that every effort will be made to achieve a successful outcome and to provide safe in-hospital care and handling. I hereby authorize this veterinary facility to receive, prescribe for, treat, or perform surgery on the pet listed on the form with my consent. Furthermore, I agree to pay fees for services rendered at the time of service. I agree to pay for the costs of collection in the event that collection efforts become necessary. I understand that veterinary service is provided during nighttime hours only at the local emergency clinic. Continuous of qualified personnel during nighttime hours are not provided at this clinic.

By acknowledging  this form, I give Stone Ridge Veterinary Medical Center permission to save my debit/credit card for future transactions. Future transactions include but are not limited to: invoices not paid for at the time of service, last-minute appointment cancellations or appointment no-shows.

(1). An 'intent to charge' text will be sent 24 hours prior to the card being charged.

(1) Last minute cancellations and no shows take away from our limited appointment times that would have allowed our doctors to see other patients. Should you need to cancel an appointment, we ask that you do so before 5 p.m. the day prior to your scheduled visit. If not, you may be charged for the missed appointment that would be congruent to $61.28 - $76.28, based on the type of appointment missed.