Cat FVFL Contract
Sign in to Google to save your progress. Learn more
Customer hereby acknowledges reading and understanding the Brochure on Free Vaccinations for Life Program provided to him or her for FreeVaccinations for Life Program to be provided for their pet. *
Customer understands that this FVFL Program will last as long as Customer has said pet and as long as said pet gets an annual Wellness Care Visit(required, charges do apply for the Wellness Care Visit) at either Willow Creek Veterinary Service or Westside Family Pet Clinic, or a combination of the two clinics. *
Customer agrees to pay the sum of $175.00 as the enrollment fee for their pet to be enrolled in the Free Vaccinations for Life Program. *
Customer understands that said fee is non-refundable and non-transferable. If said pet should die or is lost or rehomed or is otherwise no longer Customer's care, it cannot be transferred to a new pet or a new owner. Wellness visits at any other veterinary clinic do not fulfill the requirements to stay enrolled in the FVFL Program. Again, the annual Wellness Care Visit is required for continued enrollment in the FVFL Program, and charges do apply for the annual Wellness Care Visit. *
Upon payment of the enrollment fee and pet's enrollment in the FVFL Program, Veterinarian agrees to provide the following services: (A) Rabies (every 2 years); (B) HCPCH (every 2 years); (C)Leukemia, yearly (included with program at 1⁄2 price); (D) 10% off spay or neuter surgery; (E) 10%off one annual dental cleaning; and (F) 10% off one annual Feline Triple Test. *
Customer understands that to stay enrolled in the FVFL Program, the pet must be seen for an annual Wellness CareVisit in a timely manner. If Customer’s pet is more than one calendar month late for the Wellness Care Visit, said pet will no longer be enrolled in the FVFL Program. Sick visits and Emergency visits do not count as a Wellness Care Visit, nor do Wellness Care Visits at any other veterinary clinic. *
Customer understands that if more than thirteen months have passed since pet's last Wellness Care Visit, vaccinations will be charged at full price or the pet may be enrolled again after payment of the enrollment fee, which may be subject to change. *
What day did you receive the brochure on Free Vaccinations for Life Program? *
MM
/
DD
/
YYYY
What is your first and last name? *
What is the name of the pet that is to be enrolled in this program? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy