Your Name (Owner):
Home Address:
Co-Owner’s Name:
How did you FIRST hear about us?

Photo Release: I hereby give Sherwood Family Pet Clinic permission to take photographs of me and my pet for the purpose of posting on Sherwood Family Pet Clinic's Facebook, Twitter, and clinic website. I hereby release and discharge Sherwood Family Pet Clinic from any and all claims arising out of use of the photos. I am above the age of 18. I have read the foregoing statement and fully understand its contents.

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Species:
Species:
Species:

In the interest of quality client service and good business practice, we

would like to communicate the following:

Our credit policy requires that charges resulting from care given to

your pet are due and payable in full at the time your pet is discharged. Some

services may require a deposit when leaving your pet in the clinic for care.

We are happy to provide you with an estimate for any services that your

pet may need. Please ask for an estimate if you would like one.

Returned/NSF checks will be subject to a $25.00 fee, as specified by

state law.

In the event that a balance due is left unpaid, a monthly interest fee will

accrue on that balance of 1.5% per month. Interest due will start to accrue

the day after your pet is discharged from the clinic.

In the event that, for whatever reason, you are unable to pay the

balance due at the time of service, any other payment arrangements with

us must be arranged and approved before the work is performed. Again,

please ask for an estimate if you would like one. It is your responsibility to

let us know ahead of time if you are unable to pay at the time of service.

Please feel free to ask if you have any questions.

I have read and accept the credit policy terms outlined above. I agree that in the

event additional costs and/or fees are incurred in connection with the collection of

my account, I will pay all such costs and fees, including collection costs, attorney

fees and all court costs.

Name:
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