Veterinary Website Designers Service Agreement

*NO CREDIT CHECK is required to set up your Veterinary Website Package.

VISA / MASTERCARD / DISCOVER / AMERICAN EXPRESS are guaranteed to be accepted when you sign up for an E-commerce website.

Web Hosting is for one year, renewable thereafter on a yearly basis. No lengthy contracts to sign.

Just fill out the information below and we'll have your new veterinary website online in just a few days!

HOSPITAL INFORMATION

* Hospital Name

* Street Address

Address Line 2

* City

* State

* Zip Code

* Phone Number

FAX

* Email Address

WEBSITE INFORMATION

* Do you already have a Domain Name?

Yes

No

If "YES", what is your domain name?

If "NO", what domain name would you like?

Alternative choice for a Domain Name if your first choice is unavailable?

* Do you want the Interactive Appointment Book for $39.00 per month?

Yes

No

* Which Veterinary Website Package do you want?

Premium

Standard

Budget

ACCOUNT INFORMATION

* Website Owner's First Name

* Last Name

Position

* Name on Card

* Credit Card Type

* Credit Card Number

* CCV (3-digit code on back of credit card)

* Expiration Date (mm/yy)

* Credit Card Billing Address

* City

* State

* Zip Code

Your credit card will be charged to VIRTUAL CLINICS for monthly web hosting. Your monthly hosting fee wil be automatically charged to the credit card you have provided. Providing Veterinary Website Designers with your credit card information constitutes your acceptance of this Agreement and all of the terms and conditions contained herein. Hosting services are automatically renewed on a year-to-year basis. You may cancel your website services after you have completed one year of web hosting by giving Veterinary Website Designers 90-days written notice prior to your contract renewal date. Request for cancellation of website services must be submitted in writing by the credit card account holder. Third parties may not request cancellation of website services. If written request for cancellation is not received 90-days prior to your contract renewal date, you may terminate your website services by paying the balance of your hosting fees due on your current contract without penalties or interest. By clicking SUBMIT, you confirm that you have read and agree to all of the terms and conditions as stated herein and as contained in the content of this website concerning all fees in connection with website setup, merchant accounts, web hosting and website services, and that you authorize Veterinary Website Designers to establish an Internet website in your name. If you agree, click on SUBMIT.

* Indicates Response Required