Under the laws of HPAA (Health Insurance Portability and Accountability Act), we can not disclose any personal information about you or your pet to anyone unless otherwise specified by you.
***ALL FEES ARE DUE AT TIME SERVICES ARE RENDERED***
- Should I fail to pay for any services rendered by Central Veterinary Hospital, I will be responsible for all service charges (18%), collection charges (33%), attorney fees or court costs incurred by the hospital. I understand that I am responsible for keeping this information current and that any outstanding charges on this account will be my responsibility
Date Format: MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.