Wellness Sign-up Sheet

Fieldset

  • The Senior Add-on is not a stand-alone Plan. It must be added to one of the three Wellness Plans.
  • If you are putting more than two horses on Wellness, you may complete this form, and then call our office at (352) 472-1620 to complete your order.
  • Please be aware that Wellness Plans do not include trip charges. We will charge your credit card on file at each visit for trip charges, additional medications, and other services, as applicable. If you bring your horse(s) to our Clinic for their Wellness appointments, then there is no trip charge!
  • We accept the following forms of payment: ACH (Bank Draft) *preferred method! - Personal Check (upfront payment only) - All major credit cards/ debit cards.
  • Monthly payments are made by credit card, or by ACH withdrawal from your checking/savings account, also known as a bank draft. You must also provide a valid secondary credit card, which will be billed in the event that there are insufficient funds in your bank account, or if your primary card is denied. You may choose to have your payment made on the 1st or the 15th of each month. Note: There is a $5 administrative fee each month for this service. If you choose monthly installments, please be sure to fill out the credit card information as well as the bank account information for ACH!
  • By submitting this form, you are authorizing Springhill Equine Veterinary Clinic to either charge your credit or debit card, or draft your bank account, as specified by your responses.
  • If you have any questions, need to add horses, change your order, or give us payment information, please call our office at (352) 472-1620.
 

Verification