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Welcome!
Please fill out & submit this form for us! -SBPH
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    We provide our clients with online access to their pet(s) records and the ability to receive medical and appointment reminders, news and other updates by email.
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    United States
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    In case of emergency...

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    -
    Pick a Date
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    Name, Location and Contact Information of Prior Veterinary Hospital(s)
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    This form supports telling us about 4 pets in your home. If you have more than 4 pets, please let our receptionists know and we will happily collect information to add them to your account. 

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    If you select No (meaning you prefer to personally contact us) to release medical information on your pet, please keep in mind that we will have to contact you for consent before giving out any information. This may be time-sensitive in the cases of you dropping your pet off at grooming facilities, boarding, etc. that may not have your pet's updated records.
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    FINANCIAL POLICY:

    Our clinic accepts Visa, Mastercard, Discover, and American Express. We also accept cash.
    *We do not accept checks.

    In addition, we also offer several 3rd party financing options for our clients via Care Credit and Scratchpay. We accept a variety of Care Credit plans based on the total transaction amount for your pet. Care Credit requires that payment only be made for services as they are rendered, we cannot charge services to your account in advance. Therefore, Care Credit cannot be used for PAW plan services. Additionally, use of Care Credit requires that the card be present every time and that two forms of identification may need to be verified. We appreciate your understanding of our desire to protect your account/identity.

    As financing options are offered, we cannot offer additional in-house payment plans for our services. Clients needing additional financial support are encouraged to apply for Care Credit with a co-signer.

    Full payment is due at the time of service. Your signature below indicates your agreement with these policies.

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    TREATMENT CONSENT:

    By signing this document, I declare I am the lawful owner of all listed pets and all information is true and correct to the best of my knowledge. I hereby authorize the veterinarian(s) of St. Boni Pet Hospital to examine, prescribe for or treat the my pet(s) to the best of their abilities. I assume responsibility for all charges incurred in the care of this animal. I acknowledge that medical information will not be released to anyone not indicated on this form without my express verbal and/or written permission with the except of another veterinary facility.

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    Signature Required
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