Pre Register Your Pet In an effort to ensure our clients enjoy a swift and efficient visit at Stone Ridge Animal Care we have provided 2 options to pre register your pets. Clients may complete the form fields listed below and simply click submit or download a blank form to complete and bring with you on your first visit. Download Client Registration Form Download, complete and bring this form with you on your first visit. Submit Client Registration Form Online Simply fill in the fields below fully and submit. Name Owner's Full Name Email Home Ph. Cell Ph. Address City, State, Zip Code Owner's DOB Driver's Lic. # Employer Employer Ph. Employer Address Employer: City, State, Zip Spouse's Full Name Spouse's Email Cell Ph. Spouse's DOB Spouse's Employer Spouse's Employer Ph. Number of Pets * ONE TWO THREE FOUR Pet Name (1) DOB or Age (1) Pet One Sex Pet One Sex MALE MALE NEUTERED FEMALE FEMALE SPAYED Breed / Color ALL PAYMENT IS DUE AT TIME OF SERVICES Payment in FULL is due the day of service for outpatient services. If your pet is here for surgery, hospitalization, or boarding a deposit IS required and the balance must be paid in FULL when you pet goes home. Thank you. Please Indicate Payment Method * Please Indicate Payment Method CASH PERSONAL CHECK CREDIT CARD FINANCIAL RESPONSIBILITY AGREEMENT I understand that I am responsible for all charges for the care of my pet(s) provided by Stone Ridge Animal Care, LLC. I understand a finance charge of 2.00% monthly, (24% Annual Percentage Rate) will be charged on any past due balance should the account become 30 days delinquent. I understand a $40.00 fee will be assessed for any returned checks and added to the account. I understand that if any unpaid balance is assigned to a third party collection agency for collection or placed with an attorney to obtain judgment or otherwise satisfy payment of my account a collection fee of 35% will be added to my account. I agree to pay that fee. I further agree to pay reasonable attorney fees and court costs. I understand and agree to the above terms. payment disclosure I have read, understand and agree to the terms of the Stone Ridge Animal Clinic's Financial Responsibility Agreement.