Name *

First Name

Last Name

Phone *

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Card Use Authorization *

By checking this box, I authorize Vet Connection to use my payment information to process monthly payments for the duration of my Wellness Membership (12 months).

Vet Connection's membership program runs from January-December. New enrollments which take place after January of a given year will be charged the total amount of membership fees to get "caught up" to the current month. *

I acknowledge that I will be charged membership fees from January to the current month upon enrollment.

The Wellness Membership is designed to spread the cost of wellness care out over the course of 12 months, but we understand that some of our clients prefer not to have recurring charges to their card, so we are able to charge the amount for the full year of membership at once if that is preferred. *

Please select your preference below.

Monthly (payments withdrawn on the 1st of each month)

Annually (one payment for the full year will be withdrawn at the time of enrollment)

This payment information will be stored to your account to be used for monthly membership payments on the first of every month.

Check here if you would like us to process payments for future Vet Connection services/products using this payment method (if not selected, we will continue to invoice you via email/text).