By submitting this form, I hereby authorize Animal Friends Dermatology to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I understand that payment is expected in full at the time services are rendered, and assume full financial responsibility for all diagnostic and therapeutic procedures. I agree to make full payment for all services with cash, check, Visa, Mastercard, Discover, Care Credit or American Express. I agree to pay reasonable attorney’s fees and collection cost should collection become necessary.
By submitting this form I agree that I understand that Animal Friends Dermatology has the right to charge for canceled or broken appointments without 24 hours advance notice $65 for New patient appointments, $30 for Re-evaluation appointments, and $150.00 for Procedure appointments.