New Client Information Form

Client and Patient Information

Email Us Here: Boerum Hill: [email protected] | Bay Ridge: [email protected] | Yorkville: [email protected]

Download PDF Version Here

Payment Terms: Payment is required when services are rendered. We accept cash, Visa, MasterCard, American Express, and debit cards. A deposit of 50% of the low end of your estimate is required on all patient admissions and the balance is due upon patient discharge.

Client Agreement: I understand and affirm that I am at least 18 years of age. I give permission to One Love Animal Hospital to perform diagnostic, surgical, and medical treatment as deemed advisable. It is understood that such procedures or medical treatment will be discussed with me before proceeding except in emergency situations. In cases of surgery and medical procedures, it is not possible to determine in advance the extent of treatment required, and I understand that the actual cost may be lower or higher than the estimate presented to me. I assume financial responsibility for all charges incurred and agree to pay all such charges at the time services are rendered. I also understand that if I fail to pick up my pet, the animal will be considered abandoned. In doing so, I understand that this does not relieve me from my financial obligation. Additionally, I understand that in the event of non-payment I will be subject to all billing toward further care and finance/collection charges associated with my account. I also understand that One Love Animal Hospital is not responsible for any items left with my pet, including but not limited to carriers, leashes, toys, clothing, etc.