White Rock Veterinary Hospital does not share your information with any other establishments or individual. The
information requested on this form is required to set up and maintain a file with White Rock Veterinary Hospital
For your convenience, we accept cash, personal checks, Visa, Master Card and Discover. Payment is expected at the time
services are performed. When more extensive care is necessary, financial arrangements can be made with our hospital
through Care Credit or Citi Health Card.
I also agree should it become necessary to forward my account for collection proceedings, in addition to the amount I
owe, I will also be responsible for the fees associated with the costs of collections.