Consent and Financial Responsibility Agreement

As a condition for treatment at Anza Animal Clinic, payment is due in full at the time of each visit, including emergency visits. Requests for financial arrangements must be made in advance of treatment; otherwise, such requests will be declined.

Any unpaid balance will incur a service charge of $6.00 per month and a finance charge of 1.75% per month (21% annually) unless other written arrangements are in place. If this account requires referral to a collection agency, reasonable costs, expenses, and attorney’s fees will be added to the balance. Returned checks will incur a $20.00 fee.

As the owner or authorized agent of the owner, the undersigned consents and authorizes the staff of Anza Animal Clinic to provide care, treatment, and anesthesia as necessary, including surgical or therapeutic procedures determined appropriate for the patient(s). The undersigned agrees to accept financial responsibility for all services and to pay all charges at the time of service or prior to the animal’s release from the hospital. A written estimate for expected services will be provided upon request, though it may not include unforeseen services or therapeutics that become necessary during treatment.

If any animal is not collected within 10 days of notification for release, it will be considered abandoned, as outlined in sections 1834.5 and 1834.6 of the California Civil Code. Abandonment does not release the undersigned from the obligation to pay all accrued veterinary service costs.

Anza Animal Clinic may provide veterinary services during nighttime hours as deemed necessary by the attending veterinarian.

By signing below, the undersigned authorizes Anza Animal Clinic to use photos or information related to the pet’s experiences at the clinic for social media, news media, promotional materials, articles, and/or photographs, without expectation of payment.