Client Information Form

By signing below, I hereby authorize the veterinarians or Premier Paws Veterinary Service, LLC to examine, prescribe for, or treat the above-described pet(s). I assume responsibility for all charges accrued in the care of this animal. I understand that ALL CHARGES ARE DUE AT THE TIME OF SERVICES ARE RENDERED AND/OR AT THE TIME OF DISCHARGE. A $35.00 service charge will be incurred on any returned payment. Estimates are based on your pet’s status and may change if medically appropriate. Any verbal or written estimate of charges is only a best approximation, and the final charges may be less than or greater than this amount. All prices are subject to change without notice. Deposit is required for surgical procedures. If fees for services are not paid in accordance with, the provisions herein, reasonable attorney’s fees, plus applicable finance charges can be applied to all amount that are at least 30-days past due at the rate of 2% per month. If the account is in default and turned over for collection, I acknowledge that I will be responsible for a $35.00 fee and all reasonable costs associated with effecting collection. I verify that all information provided is accurate.

Premier Paws payment policy is payment at time of service. Please indicate your method of payment.