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Home > New Patient Center > New Patient Form - Acupuncture
Please provide the information below as completely as possible. All information is strictly confidential.
understand, by indicating I agree and submitting this registration, that I am responsible for any charges incurred by my pet while in the care of the doctors at Park Street Veterinary Clinic and that charges are due and payable at the time of service, unless other arrangements are made in advance. Any balance that is carried over a period of 30 days will accrue a monthly finance charge of 1.5% or 18% APR. Any balance that I leave unpaid will be forarded to Park Street Veterinary Clinic's collection agency, and will incur a 25% collection fee for which I am liable, in addition to monthly finance charges.