Purina Pro Plan Vet Direct
Annual Veterinary Disclosure Form
Church Hill Animal Hospital 322 N. 25th Street Richmond, Virginia 23223
(Please read carefully before signing)
Church Hill Animal Hospital is a full-service veterinary medical and surgical facility. We are open for business as follows:
Monday through Friday for scheduled curbside appointments:
9:00 am to 12:00 pm and 2:00 pm to 5:00 pm,
(Between 12: 00 pm and 2:00 pm, we rotate staff lunch breaks as well as extra cleaning and sanitizing the facility so there will be limited staff availability)
Surgical and Sedated-Drop off appointments are between 7:45 am and 8:30 am
We are closed on Weekends
We are closed on Major Holidays (New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day)
We will also be closed the day after Thanksgiving, Christmas Eve and close half day (12:00 pm) on New Year’s Eve.
This disclosure form is provided to inform you that we have no in-house, on-duty continuous medical staff care as follows:
1.) Overnight, from closing time at 5:00 pm to opening at 7:30 am.
2.) Weekends, from closing on Friday at 5:00 pm to opening on Monday at 7:30 am.
3.) Holidays, from closing time before the holiday at 5:00 pm (except New Year’s Eve, closing at 12:00 pm) to opening time the next business day after the holiday at 7:30 am.
If you have questions concerning this policy or would like continuous overnight care for your pet, discuss those options with the doctor.
I have read this form, and I am aware of the above staffing hours.
Annual Client Information Update Form
Address Line 1
Address Line 2
District of Columbia
Secondary Primary Phone
Secondary Other Phone
Secondary Employer's Name
PROFESSIONAL FEES ARE DUE AT THE TIME SERVICES ARE RENDERED.
We will gladly prepare a written estimate if requested. We accept Master Card, Visa, cash and checks with ID. Returned checks will acquire a $35.00 processing fee. In the event this account is turned over for collection, the owner/agent is responsible for fees in the amount of 33 1/3% of the outstanding balance.