New Client Form

To prevent the spread of infectious diseases and parasites, all hospitalized animals must be current on all core vaccinations and be free of internal and external parasites. Owners of pets in need of specific treatment(s) will be responsible for fees necessary to insure this.

I grant permission to Bath-Brunswick Veterinary Associates (BBVA) to take and use: photographs and/or digital images of myself or my pets for use in news releases, social media posts, websites and other marketing or educational materials. I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of BBVA.

PAYMENT IS REQUIRED AT THE TIME SERVICE IS PROVIDED

Collection Agency Fee: I understand and accept that if I fail to pay my account bill or any monies due and owing Bath Brunswick Veterinary Associates (BBVA) by the scheduled due date and fail to make an acceptable payment arrangement to bring my account current, BBVA may refer my delinquent account to a collection agency. I further understand that if BBVA refers my account balance to a third party for collection, a collection fee will be assessed and will be due in full at the time of the referral to the third party. The collection fee will be calculated at the maximum amount permitted by law, but not to exceed (33.3%) of the amount outstanding. For purposes of this provision, the third-party may be a debt collection company or attorney. If a lawsuit is filed to recover an outstanding balance, you shall also be responsible for any costs associated with the lawsuit such as court costs or other applicable costs. Finally, I understand that my delinquent account may be reported to one or more of the national credit bureaus.

A $30.00 fee will be charged on all returned checks. Collection action will be taken on any unpaid balance over 90 days and an appropriate fee will be assessed. I have read the above information and agree to abide by the conditions expressed above.