Online Pharmacy
Good Friends Animal Hospital Logo

Call Us

(217) 344-1017

Email Us

goodfriendsah@gmail.com

Location

908 E Main St, Urbana, IL 61802

Please Note: We will be closing early at 12 PM on Wednesday, November 27th and will be closed on Thursday, November 28th for Thanksgiving!

New Client Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. We look forward to meeting you soon!

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New Client Form

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Owner
Address

This information will not be sold! It is for our records only to effectively communicate about your pet.

How did you learn about our clinic?

Patient Info

Sex
Do you have a second pet?
I understand that payment is due at the time of service and that Good Friends Animal Hospital does not offer payment plans. If paying by check and it is returned by the bank, I agree to pay a $25 NSF fee to Good Friends and understand I will not be able to pay by check in the future. We accept Visa, Mastercard, Discover, Apple Pay, debit, CareCredit, cash and check. If I fail to pay my bill, I agree to pay all reasonable costs you incur to collect this debt. This includes, unless prohibited by law, all reasonable attorney’s fees, filing fees, court costs, collection agency costs, service fees, and other related collection costs or contingencies. I understand that if any unpaid balance is turned over to our collection agency that a fee ranging from 30%-50% will be added to the total balance due. I hereby give you or any of your agents or assignees to whom you turnover any unpaid balance permission to obtain a report from a credit reporting agency and to take reasonable steps to verify my credit and or employment information. I give you or any of your agents or assignees to whom you turnover any unpaid balance to contact me regarding this transaction or any future transaction at any telephone numbers of which they are aware including cellular telephones by manually dialing, using an auto-dialer or prerecorded message.
I also give permission for Good Friends Animal Hospital to release my records to grooming facilities, boarding facilities, and other veterinary clinics that call to obtain a history of my pets. My consent for records is perpetual unless revoked in writing and countersigned by clinic staff.

I understand this agreement, agree to these terms for service, and am singing this agreement voluntarily.

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