Pet Registraion Form
If other, please specify.
If your pet is not fixed, please choose intact.
I Understand that if the doctors are unavailable for after hours emegency care that one of the nearest 24 hour emergency clinics is Pet Emergency and Specialty Center; TEL # (619) 462-4800. In the event that I/we have failed to pay for services provided by this office in accordance with forgoing requirements, and the account is placed for collection, I/We understand and agree that an additional amount equal to 50% of the balance owing at the time the account is placed for collection, will be added to the current balance. In addition to a collection fee of 50% of the balance owed, I/We agree to pay interest at the rate of ten (10%) per annum until the balance is paid in full. I/We further agree to pay all attorneys fees and court cost. There will be a $25.00 service charge for any check returned unpaid.
PLEASE BRING IN ANY VACCINE RECORDS YOU HAVE FOR YOUR PET/S
Do Not Fill This Out