• Surgery Release

  • Date
     - -
    2 digit month, 2 digit day, 4 digit year

  • Pet History

  • Is your pet current on vaccines? *
  • Is the dog or cat on Heartworm preventative? Heartworm disease is an anesthetic risk.*
  • Has your pet been checked for Intestinal Parasites in the last 6 months? *
  • Any vomiting, coughing, or diarrhea lately? *
  • Did your pet eat after midnight?*
  • Is your pet ALLERGIC to any drugs?*
  • Has your pet had any illness or injury in the past 30 days?*

  • Would you like any of the following elective prcedures to be done at the same time:

  • Do you need a HomeAgain microchip? If the answer is yes, please go to our online HomeAgain registration form and fill it out.
  • Teeth Cleaning (Ultrasonic Scaling and Polishing)
  • Routine Nail Trim
  • Express Anal Glands
  • Bath -- Expressing anal glands and nail trim included
  • If fleas are seen, give Capstar, a tablet that kills fleas for 24 hours
  • Submission of growth to the lab with growth removals

  • PRE-OPERATIVE BLOOD PANEL

    REQUIRED FOR ALL ANIMALS OVER 6 YEARS OLD AND STRONGLY RECOMMENDED FOR PETS UNDER 6 YEARS OLD

    As part of our commitment to offering the safest care for your pet that we can during its visit for surgery, we will perform a physical examination prior to anesthesia. We strongly recommend that a  pre-operative blood screen be performed to insure that the risks of the anesthesia to your pet's health are kept to a minimum. This blood panel allows us to determine if there are any underlying problems that might lead to complications during or after anesthesia, problems which are not always evident on a physical exam.

     

  • Pre-Operative Bloodwork: $81.46*

  • PAIN MANAGEMENT

    Additional pain control is an option available for your pet. Various forms of pain control are available; the cost will depend on the type of pain control administered and the weight of the pet. Additional pain control is mandatory for all feline declaws.

  • Additional pain medication.*

  • I hereby authorize the use of such anesthetics as you deem advisable and performance of surgical or theraputic procedures as you determine to be indicated. I agree to indemnify and hold you harmless from and against any and all liability arising out of the performance of any procedures listed above.

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
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