I am responsible, and agree to pay in full, the total charges for services rendered at the time of discharge and any fees incurred for collection of said charges. I understand that fees are based on treatment deemed necessary at the time of exam, treatment, or admission and that the estimated fee may change by the administration of treatment, medication, surgery, or diagnostic test. By signing this form, I agree that Companion Pet Hospital may use photographs/videos of me and my pets for publicity, illustration, advertising, and web content. *
Please type your name below to acknowledge that payment is due at time of service -- we accept cash, check, all major credit cards, Care Credit, and Scratchpay.