SOUTHERN CROSS VETERINARY CLINIC CLIENT REGISTRATION AGREEMENT
GENERAL
1. I hereby certify that I am the legal owner of all the pets that are listed under my file at this facility from time to time,
and that I am liable for all expenses incurred on their behalf at this facility.
2. I undertake to ensure that an adult person presents all pets for treatment, and am aware that the staff at this facility
will be unable to accept instructions for treatment from anyone under, 21 years of age.
3. When leaving my pets in the care of others (holiday, overseas, hospital etc) I will make provision for a responsible
adult person to act on my behalf,
3.1 Giving them express consent to contract with this facility on my behalf with respect to my pet’s well being.
3.2 Enabling them to pay deposits and other payments on my behalf.
Should I fail to make such arrangements, I hereby unconditionally undertake to abide by the decisions made in good
faith in my absence by the staff at this facility, and declare myself unconditionally responsible for the payment of
all professional fees for such treatment.
4. I hereby authorize the facility to, euthanase any of my animals if they are adjudged to be suffering from a terminal or
irreversible condition.
5. If I am not contactable telephonically prior to such an event, I will abide by the decision of the professional staff at this
facility and indemnify them against any court action in this regard.
PAYMENTS
6. I acknowledge that all accounts are payable in full upon presentation.
7. I am aware that payment is due on presentation of invoice at this facility, and undertake to make payment by cheques, cash,
credit card or debit card/ ATM card or electronic transfer only
8. I undertake to pay at least a deposit equal to one half of the pre-estimated account prior to discharge, and accept that such
deposit is an absolute pre-condition. I will settle any outstanding balance by way of three post-dated cheques.
9. I undertake to inquire as to the extent and approximate costs of a proposed treatment, failing which I unconditionally accept
that I am liable for the costs thereof.
10. I hereby render myself responsible for all costs, including interest at a rate of 1.5% per month and an administration fee as
determined from time to time by the facility, incurred in the recovery of the outstanding amount from time of presentation of
the account.
11. In the event that an account is handed over to your Attorneys or other agent for collection, I irrevocably agree to pay for all
costs on an Attorney and Client scale, Legal Counsel on their agreed scale, collection commission, (including the costs and
collection commission of any correspondent Attorney employed by your Attorneys or agent in connection therewith) and
interest thereon at the rate of 1.5% per month.
Signed at this day of 201
_________________________________________
Full names:
ID Number:
_________________________________________Witness
SAVA surcharges applicable on after hours consultations
GENERAL
1. I hereby certify that I am the legal owner of all the pets that are listed under my file at this facility from time to time,
and that I am liable for all expenses incurred on their behalf at this facility.
2. I undertake to ensure that an adult person presents all pets for treatment, and am aware that the staff at this facility
will be unable to accept instructions for treatment from anyone under, 21 years of age.
3. When leaving my pets in the care of others (holiday, overseas, hospital etc) I will make provision for a responsible
adult person to act on my behalf,
3.1 Giving them express consent to contract with this facility on my behalf with respect to my pet’s well being.
3.2 Enabling them to pay deposits and other payments on my behalf.
Should I fail to make such arrangements, I hereby unconditionally undertake to abide by the decisions made in good
faith in my absence by the staff at this facility, and declare myself unconditionally responsible for the payment of
all professional fees for such treatment.
4. I hereby authorize the facility to, euthanase any of my animals if they are adjudged to be suffering from a terminal or
irreversible condition.
5. If I am not contactable telephonically prior to such an event, I will abide by the decision of the professional staff at this
facility and indemnify them against any court action in this regard.
PAYMENTS
6. I acknowledge that all accounts are payable in full upon presentation.
7. I am aware that payment is due on presentation of invoice at this facility, and undertake to make payment by cheques, cash,
credit card or debit card/ ATM card or electronic transfer only
8. I undertake to pay at least a deposit equal to one half of the pre-estimated account prior to discharge, and accept that such
deposit is an absolute pre-condition. I will settle any outstanding balance by way of three post-dated cheques.
9. I undertake to inquire as to the extent and approximate costs of a proposed treatment, failing which I unconditionally accept
that I am liable for the costs thereof.
10. I hereby render myself responsible for all costs, including interest at a rate of 1.5% per month and an administration fee as
determined from time to time by the facility, incurred in the recovery of the outstanding amount from time of presentation of
the account.
11. In the event that an account is handed over to your Attorneys or other agent for collection, I irrevocably agree to pay for all
costs on an Attorney and Client scale, Legal Counsel on their agreed scale, collection commission, (including the costs and
collection commission of any correspondent Attorney employed by your Attorneys or agent in connection therewith) and
interest thereon at the rate of 1.5% per month.
Signed at this day of 201
_________________________________________
Full names:
ID Number:
_________________________________________Witness
SAVA surcharges applicable on after hours consultations
