New Client FormPark City Animal Clinic

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Thank you for giving us the opportunity and care for your pet. Please take time to fill out this form completely.

I hereby authorize the veterinarians at Park City Animal Clinic to examine, prescribe for or treat the animal described above. I assume full responsibility for all charges incurred in the care of my pet. I understand that the payment is due in full at time of service. A deposit may be required for major medical and surgical procedures.

 

In the event there is an open balance on my account, a financial arrangement must be made and any balance may be subject to a monthly billing and a financing fee equal to 1.5% of the unpaid balance.

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