Wellness Plan-Terms and Conditions
Wellness Plan: Basic Adult
Enrollment Fee: $40.00
Price Per Month: $37.99
Basic Adult Wellness Plan includes the following services:
Examinations Vaccinations Diagnostics
*Physical/Well Exam (unlimited)
*Sick Exam (Unlimited)
*Fecal Flotation (2)
*Follow Up Exam (Unlimited)
*Microscopic Ear Exam
*Complete Blood Count
*Organ Function Profile
Parasite Control Surgical Procedure Boarding/Grooming
*Dental Cleaning OR Spay/Neuter (includes enamel strengthener and antibiotic injection OR includes pain control injection and antibiotic injection)
*2 nights of boarding in a single run
*2 days of daycare
*2 Toe Nail Trims
*2 Ultimate spa packages (This is NOT a haircut)
(includes, bath, fluffy dry, brush, toe
nail trim and spritz of cologne)
**Spay or neuter with antibiotic injection and pain medicine injection can be substituted for the dental**
The enrollment fee and the first month’s payment is due in full today. This agreement is good for 12 months from the start date listed above. Any services not used in the 12 month period are not transferable to the next year and are non-refundable. The contract is effective on the day it is signed, any veterinary services performed before this date are not relevant to this plan.
I understand the services included in the Basic Adult Wellness Package.
Option 1: Automatic Monthly Deduction from Checking/Savings Account
ELECTRONIC TRANSFER (ACH) ORIGINATION AGREEMENT
AUTHORIZATION AGREEMENT FOR DIRECT PAYMENTS (ACH DEBITS)
I (we) hereby authorize Animal Care Center, herinafter called COMPANY, to initiate credit entries and to initiate, if necessary, debit entries and adjustments for any credit entries in error to my (out) [ ]Checking [ ]Savings account (select one) indicated below and the depository names below, hereinafter called DEPOSITORY, to credit and/or debit the same to such account. I (we) acknowledge that the origination of ACH transactions to my (our) account must comply with the provisions of U.S. law.
CITY______________________ STATE________ ZIP___________
ROUTING NUMBER_______________________ ACCOUNT NO._______________
Type of Account:
Checking Account____ Savings Account____
This authorization is to remain in full force and effect until Company has received written notification from or (or either of us) of its termination in such time and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on it.
(In order to insure the correctness of the Depository information, please attach a voided check (checking) or blank deposit ticket (savings) to this Authorization Form).
Option 2: Monthly Charge to Credit Card
Animal Care Center Credit Card Authorization
Visa, Master card, Discover, Care Credit (circle one)
I authorize the Animal Care Center to charge the above credit card $37.00 per month.
This agreement and the services provided under it are not transferable to another Pet or assignable to another person. This agreement applies only to the Pet designated above while owned by client.
Any services included in the plan that are not used within the 12 month period are not transferable to the next year and are non-refundable.
Client must be 18 years of age
Wellness Plans are not insurance
Fees for services not included in the wellness plan will be at regular price and must be paid in full at the time the services are rendered.
Exclusions: The following items and services are not included in this Agreement:
Services including office visits and consultations rendered by specialists to whom the Pet is referred by Animal Care Center.
Services recommended as a result of injury or illness
Services at any institution, clinic, or hospital other than Animal Care Center
Monthly payment installments will be deducted from client’s bank account or charged to client’s credit card on the 5th of each month. If the 5th falls on a weekend or holiday the deduction will be made on the next business day.
An overdraft/reprocessing fee of $20.00 will be billed to client for insufficient funds, over limit status or any other reason a payment is unable to be processed based on the account information supplied by client.
Client is responsible for immediately notifying Animal Care Center of any changes in billing account information to avoid any payment reprocessing fees.
I authorize the Animal Care Center to charge my checking account or credit card $37.99 per month
This Agreement is effective on the Start Date for an initial term of 12 months
This plan will automatically renew on the anniversary of the Start Date in each succeeding year for subsequent periods of one year until client or Animal Care Center cancels this Agreement. Monthly payments will continue to be deducted from client’s bank account as well.
You will be notified by email or mail prior to the automatic renewal of your plan
If you do not want to renew your contract for the next plan year, you must contact us 30 days prior to the end of your contracted plan year. If we do not receive a cancellation notice in writing by that time, your account will be automatically renewed for the following year at the same terms.
In the event Client fails to pay any monthly installment within 30 days of its due date, Animal Care Center has the option to immediately cancel this Agreement, discontinue Plan services and declare all services rendered to date be paid in full at retail price.
After 30 days, the Client’s account will be referred to a third party collection agency and the wellness plan will not be eligible for reinstatement. Collection activity may negatively impact Client’s Credit Bureau information and is subject to additional collection fees.
Either Client or Animal Care Center may cancel this Agreement at any time, but there may be monies due upon cancellation.
Cancellation by Client Within 3 business days: If Client cancels this Agreement for any reason within 3 hospital working days of enrollment, the membership fee and any other fees paid are refundable less the undiscounted retail value of any and all services provided.
Cancellation by Client After 3 business days: If Client cancels for any reason (including but not limited to death or loss of Pet or transfer of ownership) before or after Animal Care Center has rendered services the enrollment fee is non-refundable. Animal Care Center will also be entitled to retain or recover from Client all monthly installments that have previously been paid or become due, including the installment for the month in which cancellation occurs, regardless of the cancellation request date. In addition, upon cancellation prior to the end of the Plan Year, if the total undiscounted retail value of Plan services provided exceeds the sum of monthly installments collected for that Plan Year. Member shall be obligated to do one of the following:
Immediately pay full retail fees for all services provided (with all discounts reversed as if Plan had not been in effect for the Plan Year) less the total of monthly payments received by Animal Care Center for the Plan Year; OR
Immediately pay the total remaining Plan Year monthly installments in full.
Cancellation by Provider: Animal Care Center reserves the right to cancel the Plan at any time and for any reason.
Plan Upgrades and Downgrades:
Client may elect to upgrade or downgrade the level of the current Plan without paying a new membership fee. Upgrades may be made at any time during a Plan Year and will end the existing Plan and create a new Plan at the higher level chosen by the Client. The new Plan will have a new Start Date and will be in effect for a new 12 month term, with automatic renewals on the anniversary of the new Start Date. A new Wellness Plan Agreement will be signed by client for the new plan.
Plan downgrades may be elected upon renewal at the beginning of a new Plan Year and will create a new Plan with a new Start Date and a new Plan Year as described above for upgrades. A new Wellness Plan Agreement will be signed by client for the new Plan.
Plan Price and Service Changes:. Animal Care Center reserves the right to adjust monthly fees, services and the terms and conditions of this Agreement as of the date of any renewal of this Agreement. Animal Care Center will give Client notice of any such changes no less than 30 days prior to the date they are to become effective