Veterinary Services Contract

Horse owner's physical address, if different from above

(For additional horses, please email information to , or call 540-364-4950)

1. I understand that I must pay all accounts in full within 30 days of invoice.
2. If we have not received a payment in full within 60 days of invoice, we understand that signals your consent to have account settled by immediately charging the balance to your credit card.
3. I hereby authorize Piedmont Equine Practice Inc. to provide routine care to my horse(s) in my absence ar at the request of my barn management.
4. This contract shall apply to any and all veterinary services provided by Piedmont Equine Practice Inc., and any and all horses on your behalf, whether or not the horse(s) are listed on this form.
5. Late charges shall be applied to all accounts overdue at a rate of 1.5% monthly or 18% per annum.
6. Should Piedmont Equine Practice Inc. be forced to commence administrative and/or legal action to collect unpaid invoices from you:
   1. You consent to personal jurisdiction of courts of the Commonwealth of Virginia over you,
   2. You agree to pay all costs and reasonable attorney's fees of 33% incurred by Piedmont Equine Practice Inc. that are associated with such action.
7. You represent that you are presently able to comply with the payment terms herein, and that if you should become unable to make timely payment of outstanding invoices, you will contact Piedmont Equine Practice Inc.