Understanding Our Payment Process

Payment Policy Form

We believe in clear, upfront communication. Our payment policy form outlines accepted payment methods, billing timelines, and expectations so you feel confident and informed about your visit.

Please complete this form before your appointment to streamline your check-in process.

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Payment Policy Form

MISSED SCHEDULED APPOINTMENT POLICY

We are happy to reschedule your appointment at no cost to you when we receive your schedule change request 24 hours prior to your scheduled appointment time. This will allow us to offer the time we’ve set aside for you and your doctor to another patient.

If you are not able to notify our office 24 hours before your scheduled appointment, or fail to appear for 2 scheduled appointments without 24-hour notice, we will require a credit card number to reserve your next appointment time. Upon a no-show for the third scheduled appointment, we will charge your credit card for the cost of your exam or $100.00 charge for the first missed scheduled surgery time. Additionally, we reserve the right to charge a deposit fee for any future surgeries or hospitalization of 10% to 50% of the estimated total cost.

ACCEPTED FORMS OF PAYMENT POLICY

We offer the following seven (7) types of payment options for your convenience.

Visa, Master Card, American Express, and Discover
Cash
Care Credit
ScratchPay

We do not offer any type of payment plans or delayed payment agreements of any kind. We do not accept checks.

ACKNOWLEDGMENT

Missed Appointment Policy Agreement *

1. I, THE UNDERSIGNED, HAVE READ AND FULLY AGREE TO THE ABOVE MISSED APPOINTMENT POLICY.

Payment Policy Agreement *

2. I THE UNDERSIGNED, HAVE READ AND AGREE TO THE ACCEPTED FORMS OF PAYMENT POLICY.

Responsibility Policy Agreement *

3. I, THE UNDERSIGNED, HAVE READ AND AGREE THAT I AM PERSONALLY RESPONSIBLE FOR ALL CHARGES INCURRED AND AGREE TO PAY ALL CHARGES IN FULL AT THE TIME SERVICES ARE RENDERED.

Agreement Payment Missed

Collection Fees Policy Agreement *

4. I THE UNDERSIGNED UNDERSTANDS THAT I WILL BE LIABLE FOR ANY COLLECTION FEES ASSOCIATED WITH THIS ACCOUNT, INCLUDING BILLING AND INTEREST CHARGES, AND AN ATTORNEY’S FEE OF 33 1/3% OF THE BALANCE OWING.

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Date *

For billing questions, contact our team at (757) 481-2800

Understanding Our Payment Process

Payment Policy Form

Payment Policy Form

MISSED SCHEDULED APPOINTMENT POLICY

ACCEPTED FORMS OF PAYMENT POLICY

ACKNOWLEDGMENT

Your Trusted Veterinary Clinic in Virginia Beach

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