Client Information Form

Terms and Conditions

“Patient” as used herein means the horse or horses treated, cared for and/or hospitalized at Equine Medical Center and includes the plural form, i.e. “patients”. “Client” as used herein includes but may not be limited to the Owner(s), agent(s), farm manager, trainer or secretary or other person authorized to or acting for owner, including the person(s) presenting the patient for care and treatment; all of whom are responsible for care and treatment of any sums due hereunder.

Client assumes all financial responsibilities for all charges incurred in the diagnosis, care, and treatment (including board/hospitalization if applicable) of patient and understands that full payment is due at the time of discharge of patient from Equine Medical Center, or upon termination of treatment, whichever is earlier.

Client understands and agrees that all sums remaining unpaid thirty days after the invoice date shall accrue interest at the rate of 18% and that interest applies to any balance, ever the current balance, once thirty days have passed since the invoice date.

Client understands that in the event it is necessary to utilize the services of an attorney for collection of any account, regardless of whether suit is filed, Client agrees to pay Equine Medical Center all costs and expenses of collection, including, but not limited to, reasonable attorney fees, costs of defenses, counterclaims, cross claims, third party claims, and intervener’s claims arising from or related to the treatment, care and services provided and/or collection of amount due and agrees to venue in Marion County, Florida.

Client hereby authorizes Equine Medical Center to bill the provided credit card until all fees are paid in full. Clients who choose to use their credit card for payment agree not to attempt to reverse charges through their credit card company or otherwise use their credit card to void the transactions.

Client understands and agrees that Equine Medical Center and/or the treating veterinarian may, it its/his/her/ discretion, refuse to release the horse from the facility until the invoice(s) have been paid in full. Client authorizes Equine Medical Center , P.L. and its veterinarians and staff to administer any necessary treatment of the animal or animals described above, or correction of conditions which might develop and the performing of surgical or therapeutic procedures deemed advisable by the clinician in charge, is authorized by Client. There is no guarantee that any treatment performed will be successful. Client realizes that results cannot be guaranteed. Client understands that a degree of risk is involved in the performance of the above procedures and does hereby release Equine Medical Center, P.L. and its veterinarians and employees from all liability associated with the treatment of the above described animal. Additionally, there may be complications to any procedure with the discharge instructions. A photostatic copy (including) facsimile) of this authorization shall be considered as effective and valid as the original document or electronic document.