Animal Care Center of Carters Creek
2690 Spring Meade Blvd
Columbia, TN 38401
(931) 489-9333
"Think of us as your other family doctor"
 
New Patient and Client Information Sheet
 
Thank you for selecting Animal Care Center of Carters Creek.  We welcome the opportunity to provide the very best care possible for your pet.  Please help us become better acquainted by completing the following:
Sex:
Spayed/Neutered:
Sex:
Spayed/Neutered:
Sex:
Spayed/Neutered:

CONDITIONS OF ADMISSIONS
 
Animal Care Center of Carters Creek agrees to receive from the owner the described animal and to give it such medical, surgical, and dental treatment as it may deem advisable.
 
The owner acknowledges that his/her animal is under the care of his/her personal veterinarian or any other veterinarian designated by the owner's personal veterinarian, and that the hospital shall not be liable for acts or omissions in the following order(s) of the said veterinarian(s).  The owner hereby consents to any treatment or services rendered by the hospital pursuant to the order(s) of said veterinarian(s).  The owner's veterinarian, or if said veterinarian is unavailable, any other veterinarian may be called in attendance by the hospital whenever deemed necessary or advisable by the hospital, and any and all expenses incurred thereby shall be the responsibility of the owner.  If a veterinarian other than the owner's personal veterinarian is called, as above, the owner acknowledges that the hospital shall not be liable for any acts or omissions in following the order(s) of said veterinarian.
 
The owner hereby authorizes the hospital to release information from the animal's records to any person, agency, or authority as the hospital in its sole discretion may determine necessary.
 
The hospital shall not be responsible for the loss, theft, or destruction of any personal property left with an animal.
 
The owner or financially responsible party agrees to pay upon discharge from Animal Care Center of Carters Creek the charges specified  for the care, keeping, and the boarding of the animal(s) described herewith entrusted to its care.  The owner or financially responsible person agrees to pay in full all the charges incurred during any period where payment of such charges is pending determination of insurance companies.
 
The owner agrees to move the animal(s) within 5 days after a request for removal is made.  Should the animal not be removed within the specified time, the owner hereby relinquishes all claims to the animal(s) and Animal Care Center of Carters Creek is at liberty to re-home, adopt out, or dispose of humanely of the animal(s) as it may see fit.
 
Animal Care Center of Carters Creek does not offer billing and payment is due at the time that services are rendered.  In the event an account has a balance that is 30 days delinquent it shall bear interest at the maximum legal rate.  Should the account be referred to an attorney for collection, the owner or financially responsible party agrees to pay attorney fees, collection costs, and other costs of litigation.
 
Prices are subject to change without notice.  The agreement will remain in effect until such time as a different agreement is executed.
 
If for any reason transportation has been provided to or from the hospital by our personnel, neither they nor the hospital are to be considered liable for loss or injury to you animal.
 
The owner agrees to the use of photos of their animal in and for social media purposes as Animal Care Center of Carters Creek sees fit.
 
Any paragraph that shall be deemed to be invalid shall not invalidate the remainder of the agreement.
 
 
Thank you for your coopearation and for choosing Animal Care Center of Carters Creek for your pets care,
MANAGEMENT
 
 
Signature acknowledging your agreement: *
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