Client Information

Patient Information

Plan Information

Payment Information

I understand that I will be billed for the sign up fee and first month’s payment today when I check out. I approve my credit card to be billed monthly for the additional 11 monthly payments. I understand that I will be sent home with no more than 6 months of preventative at any given time, that each plan is a 12 month, non-cancellable policy, that fees are non-refundable, and that prescription preventatives and any medications are unable to be returned. Bridgeview Animal Hospital & Pet Wellness Clinics are not responsible for overdraft fees associated with my plan. If my payment is not made within 5 days of my normally scheduled payment date, my plan will be terminated and I will be responsible for paying for the unpaid services & products. Unpaid services & products are determined by invoicing used services & products at regular cost and applying credit for the plan’s monthly payments that have been made (credit of monthly payments does not include sign up fee) I understand that if my pet has a lapse in heartworm prevention for more than 30 days, I am responsible for updating my pet’s heartworm test at my cost, prior to receiving additional preventatives.