New Client Form

AUTHORIZATION FOR TREATMENT I, the undersigned owner, do hereby authorize Blue Diamond Animal Hospital veterinarians to examine my pet and administer treatment for my pet's condition. VETERINARY GRADUATES AWAITING LICENSURE (VGAL) CONSENT Blue Diamond Animal Hospital staff Veterinary Graduates Awaiting Licensure (VGAL). While they possess the necessary skills and knowledge, it is essential to acknowledge that their licensure is pending. The well being of the animal remains the primary concern. I'm aware of this arrangement and provide consent to proceed. PAYMENT TERMS AND CONDITIONS I understand that charges will be paid in full at the time of release, and a deposit may be required for certain surgical treatments or other procedures. We accept Visa, MasterCard, Discover, Cash, and Care Credit. We apologize for the inconvenience, but we DO NOT accept American Express or checks. FINANCIAL RESPONSIBILITY I understand that should my account become delinquent; I will be responsible for any and all billing and accrued interest charges from the delinquency. I understand that as a condition of treatment by Blue Diamond Animal Hospital, any financial arrangements must be made in advance. In the event that this account should go unpaid, I understand that I will be subject to the cost of collections, including attorney fees and/or collection agency fees. AGE AND RESPONSIBILITY ACKNOWLEDGMENT By clicking 'I agree', I acknowledge that I am 18 years of age or older and am fully responsible for all charges.