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AUTUMN TRAILS VETERINARY CENTER
2407 HYDRAULIC ROAD
CHARLOTTESVILLE, VA 22901
434-971-9800

Client Information.

Animal Information.

By signing this form, I acknowledge that I am responsible for payment in full at the time of my pet’s discharge. WE ACCEPT CASH, VISA, MASTERCARD, DISCOVER, AMERICAN EXPRESS AND CARE CREDIT. WE DO NOT ACCEPT PERSONAL CHECKS!! In the event that Autumn Trails Veterinary Center (Autumn Trails) needs to engage legal counsel or incurs any expense to collect any amounts owed under this agreement and/or the services performed, you shall be responsible for paying all reasonable costs and expenses incurred by Autumn Trails, including but not limited to attorney’s fees and court costs.