New Client Form

Professional fees are to be paid at the same time services are performed.

In admitting my pet(s) for diagnostics, treatment, or surgery, I authorize the veterinarians of the Williamsburg Veterinary Clinic, and their support staff, to administer such treatment and/or perform such diagnostic or surgical procedures as deemed necessary.

It is understood that an estimate of charges will be given for services. No guarantee or assurance can be made as to the results that may be obtained.

Further, I understand that a deposit of 50% is required before services are performed and I assume full financial responsibility for all charges incurred by my pet. I realize that these charges may exceed a given estimate if complications arise. I understand that I will be contacted prior to treatment, if possible, should complications occur.

I request any and all treatment deemed necessary by the attending veterinarian and agree to pay all charges for services rendered at the time those services are rendered. I understand and agree that any charge which is unpaid shall be subject to a monthly interest charge of two percent (2%) and, should my account be assigned for collection, I will be responsible for all costs and an attorney’s fee of thirty-three and one-third percent (33 1/3%) of all monies due.