have read and understood the conditions written below and by completing this form I verify that I understand and agree to them
1) The emergency exam fee is $95.00
After examination, an estimate of charges may be reviewed with you. However, if your pet is in critical condition and in need of immediate attention, treatment will be administered prior to your receiving an estimate and you will be liable for that cost of care
2) LAEC does not offer a billing or payment plan
Full payment is due when services are rendered. If overnight hospitalization is necessary then payment is due before treatments can begin. You are liable for all charges incurred as a result of unforeseen treatments deemed necessary by the Veterinarian. Any remaining balance must be paid in full at pickup time
3) All hospitalized patients must be picked up between 7:00am and 7:30am on the morning of discharge
A $15.00 late fee will be assessed if timely pickup is not made
Please indicate which form of payment you will be using for this visit.