Please complete the form below and submit prior to your pets scheduled surgery.Thank you for your cooperation in letting us assist you.
Fields marked with an asterisk (*) are required.
Yes
No
Please select any additional items/services to be completed at the time of your pet’s appointment.
E-Collar (Cone-shaped collar to help reduce access to surgical site)
Cover Me (Cloth onsie to help reduce access to the surgical site)
None of the above
Oral Rinse (Slows build up of bacteria, sent home after procedure)
Dental Sealants (Helps lengthen time between dentals, applied during procedure)
Nail Trim
Nail Dremel
Anal Glands Expressed
Microchip
Pre-surgical blood screening In order to reduce the risks involved with anesthetizing our patients, we perform a pre-surgical blood screen to detect abnormalities not evident on a routine examination. This bloodwork panel checks blood counts, platelet counts and 10 blood chemistry levels to evaluate liver and kidney function, as well as blood glucose levels and blood protein levels. Evaluation of these levels allows us to FIRST see if anesthesia can be used safely on your pet, and SECOND allows us to adjust the dosing to exactly what your pet needs for the safest possible anesthesia and recovery...pre-anesthetic blood screening GREATLY reduces risks associated with any anesthesia. The charges for the blood screen will be added to your invoice.
Pain Control The comfort, healing and safety of our patients is our number one concern during and after any surgical procedure. Pain medication helps improve healing and decrease inflammation, aiding in the comfort of your pet. A pain injection will be given to your pet while here for their procedure, and additional oral medication will be sent home with you for post operative care. Your pet will also receive an anti-nausea injection to help with any nausea associated with the anesthesia.
We are a flea free environment. If fleas are found, we will treat at owner's expense. All anesthetics and surgeries carry risks ranging from post-op nausea to sudden death. While these occurrences are very rare, they can happen even though protective measures are taken. I, (the owner/responsible party) for the above-described animal, have the authority to execute this consent, and am over 18 years of age. I understand there is an inherent risk in anesthesia and/or surgery. I agree to the above described procedure/care, and accept full responsibility and also full financial responsibility and understand all charges are to be paid in full upon completion.
I UNDERSTAND THAT IF WE ARE UNABLE TO REACH YOU BY PHONE DURING THE PROCEDURE, WE HAVE YOUR PERMISSION TO PERFORM ADDITIONAL PROCEDURES AS WE DEEM NECESSARY.
