Schedule your payment to be automatically charged to your Visa, MasterCard, or Discover Card. Just complete and sign this form to get started!
If you’d like to change which credit card you are using, please contact Dominion Animal Hospital here.
Recurring Payments Will Make Your Life Easier:
It’s convenient (saving you time and postage)
Your payment is always on time (even if you’re out of town), eliminating late charges
Here’s How Recurring Payments Work:
You authorize regularly scheduled charges to your credit card. You will be charged the amount indicated below each billing period. A receipt for each payment will be emailed to you and the charge will appear on your credit card statement. You agree that no prior-notification will be provided unless the date or amount changes, in which case you will receive notice from us at least 7 days prior to the payment being collected.