To prevent the spread of infectious diseases and external parasites, hospitalized animals MUST BE CURRENT ON ALL VACCINES AND FREE OF EXTERNAL PARASITES. I authorize Aquia-Garrisonville Animal Hospital to provide vaccines and parasite control when needed.

Full payment is expected when services are rendered. Deposits are expected on medical, surgical, and emergency cases, where hospitalization is required. We accept the following as methods of payment: CASH / CHECK / DEBIT / VISA / MASTERCARD / DISCOVER (NOVUS) / CARECREDIT. The current state allowable charge will be assessed for any returned check. In the event of any default of payment, I agree to pay 18% interest per annum on all balances which are unpaid sixty (60) days after the services are
rendered; plus attorney’s fees which are hereby stipulated to be 33 1/3% of such outstanding balance whether suit is filed or not; plus court costs. If I fail to promptly pay for the services rendered, I authorize the release by or to any credit reporting agencies of
personal credit information on me, and I further agree to pay all costs of obtaining such credit information and/or locating me, as may be necessary.
 Signature of Owner or Authorized Representative  
  Signature *      
 
Date *    

VIRGINIA VETERINARY DISCLOSURE FORM

(Please read carefully before signing) 

Aquia-Garrisonville Animal Hospital has business hours as follows:

Monday through Friday 7:00 am - 7:00 pm

Saturday 8:00 am to 1:00 pm

Sunday - Closed

Closed on holiday eve's and holidays

We have no in-house_/ on duty continuous medical staff care

1. Overnight (Monday through Thursday), from closing time at 7:00 pm to opening time at 7:00 am and Friday overnight from closing time at 7:00 pm to opening time at 8:00 am.
2. Weekends, from closing time on Saturday at 1:00 pm to opening time on Monday morning at 7:00 am.
3. Holidays from closing time before the holiday at 7:00 pm to opening time the day after the holiday at 7:00 am.
4. Holidays falling on Monday, from closing time Saturday at 1:00 pm to opening time on Tuesday at 7:00 am.

Doctors and support staff returns intermittently for treatments and patient care during closed hours.

In the event a patient requires after hours medical monitoring, we recommend transfer to the Fredericksburg Regional Veterinary Emergency Center.

I have read this form and I am aware of the above staffing hours.

Signature *        Date *