New Clients

I hereby authorized the veterinarians & staff to examine, prescribe for, and/or treat the above-described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that any and all charges will be paid for at the time when services are rendered and that a deposit may be required for hospitalization, treatment and/or surgery. I understand that in order to protect my privacy, information regarding client and or patient information can only be released to the owners named above, and a medical record release will be verbally required to share any information at any time. VETERINARY WELLNESS CENTER of PROVINCETOWN DOES NOT OFFER BILLING. ALL PAYMENTS ARE DUE IN FULL AT THE TIME WHEN SERVICES ARE RENDERED. PLEASE INFORM EITHER A VETERINARIAN OR TECHNICIAN IF YOU REQUIRE AN ESTIMATE BEFORE SERVICES ARE PERFORMED. I have read the above statement and understand it fully.

Thank you for giving us the opportunity to take the very best care of your pets.

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