Returned Check Policy. Checks that are returned non-payable are subject to a $30.00 Service Fee. Future appointments must be paid in Cash, Visa or Mastercard PRIOR to the start of your pets next grooming. I have read and agree to the policies of Wag ‘N Wash, and have received a copy for my records. Note: This form will automatically apply to any and all additional pets acquired by above Pet Owner. Pet Owner’s Full name: Date: Pet(s) Name: Breed: Signature:
Returned Check Policy. Checks that are returned are subject to a $30.00 Service Fee. Future appointments must be paid in Cash PRIOR to the start of your pet’s next appointment.
Returned Check Policy. If a payment is made on an account by check and the check is returned as non-sufficient funds (NSF), account closed (AC), or refer to maker (RTM), the patient or patient’s responsible party will be responsible for the original check amount in addition to a $10.00 service charge. I also understand that I will be responsible for any charges incurred by not providing the most current, correct insurance information to Seven Hills Medical Center PC. Patient Name (Print) Date Patient Name (Signature) Appointment No Show/Cancellation Policy Due to high volume of scheduled appointments and in order to best serve our patients, the following policy is necessary: **We require a 24 hour notice if you are not able to make your scheduled appointment.** Failure to do so will result in an $85 charge. Payment in full is necessary prior to any treatments being rendered. The payment is non-refundable and non-transferable. By signing below, I agree that I was informed of this office policy. Patient Name (Print) Signature Date Updated Policies (2016) Due to current economic conditions, there have been a few changes to some of our policies.
Examples of Returned Check Policy in a sentence
Returned checks will be assessed an additional fee based on DEC’s Returned Check Policy.
More Definitions of Returned Check Policy
Returned Check Policy. I understand that if my check is returned, I must pay a $25.00 Returned Check Fee in cash to XXX. I understand the school has the right to request cash only payments due to one or more returned checks. Late Child Pick-Up Policy:
Returned Check Policy. You are responsible for the amount of any returned check plus a $35 returned to check fee which includes bank fees and administrative costs. Initials
Returned Check Policy. Checks that are returned non-payable are subject to a $30.00 Service Fee. Future appointments must be paid in Cash, Visa or Mastercard PRIOR to the start of your pets next grooming. I have read and agree to the policies of Wag ‘N Wash, and have received a copy for my records. Pet Owner’s Name Date: Pet(s) Name: Breed: Note: This form will automatically apply to any and all additional pets acquired by above Pet Owner. e Forms10-05LAS-REV2-2605 DIFFICULT PET NOTICE Pet/customer name: Grooming presents many risks, especially with pets that are resistant to restraint or handling. Pets that are very difficult may experience injury during grooming as a result of their OWN behavior. Reactive and jerking behavior means that there is an increased chance of cuts or nicks from the clippers or scissors. While we can use a muzzle to keep from being bitten, to make grooming possible, many pets will try repeatedly to scratch the muzzle off of their face and may injure themselves trying to get the muzzle off. We cannot safely groom the head and face of a dog that needs a muzzle and bites us or our equipment. Some dogs struggle and throw themselves against restraint so violently that they may pull or bruise a muscle. This can occur when we are simply trying to hold the pet still so we can use our (sharp) equipment safely. We are willing to try and groom your pet, despite its behavior and we will proceed with care and caution, but we will not assume liability for any vet bills resulting from injury during grooming. While cuts and nicks are rarely any more significant an injury than you would experience if you cut yourself shaving, we want to be sure you are aware of the risks, and possible vet expense you may incur. Because of the extra time it takes to handle your pet safely, in the future we will have to charge an additional $ for our grooming service. So the new price will be $ . We may have to schedule a priority groom and have you present for the entire grooming process. Priority grooming costs an additional $25.
Returned Check Policy. A $35 service fee will be charged for all returned checks.