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Frozen Semen Credit Card Authorization Form

Domestic Shipment

Recipient Information

Shipping Information

I, the undersigned, do authorize Rose City Veterinary Hospital to charge my credit card for the processing of frozen semen. I understand that the charge is $595.00 for frozen semen processing, and one week of tank rental this fee also includes shipping the semen via Federal Express within the USA. Tank rental is $15.00 per day after the initial week.

*** Please check availability for Saturday Delivery and First Overnight as there are some areas that do not provide these services*** Additional Rates may apply for Saturday Delivery or First Overnight

In addition, with less than 24 hours notice there is an additional $200.00 fee; for 48 hours notice there is an additional $100.00 fee.

By submitting this form you understand that if the tank is not returned within 30 days or it is returned damaged, you understand that your credit card will be charged in the amount of $1200.00 for replacement fees.

Federal Express offers Shipping Insurance; Insurance is $1.00 per $100.00 increment over $500.00. We recommend insuring for the value of the semen. FedEx must take possession of the package for insurance to be valid.

Payment Information

By submitting this form you authorize Rose City Veterinary Hospital to charge your credit card in the amount mentioned above. I also understand in the event the tank is not returned or is returned damaged, Rose City Veterinary Hospital, will charge my credit card in the Amount of $1200.00.

By submitting this document to Rose City Veterinary Hospital. YOU AGREE TO PAY ABOVE TOTAL AMOUNT ACCORDING TO CARD ISSUER AGREEMENT (MERCHANT AGREEMENT IF CREDIT VOUCHER)

Sign up using the form or call 626-796-8387 to make your appointment.

THIS ---->https://rosecityvets.com/patient-center/online-forms/frozen-semen-shipment--domestic-.html

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Testimonial

Have been taking my cats to RCVH for years. The Vets and office staff have always been great. My current Vet Dr. Brickman is exceptional: she took over from my previous Vet who moved away. She is very patient and listens to my concerns regarding my elderly male cat. She is a real professional.

Lori H.
Pasadena, CA

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