• Companion Animal Hospital Surgery / Dental Form

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  • Would you like a microchip implanted while your pet is sedated?*

  • Fasting for Surgery

  • Cerenia Pre Surgery Injection

    ** We strongly recommend this for any pet undergoing anesthesia for a better recovery.

  • Would you like your pet to receive an injection before it's procedure that will help with post-surgical nausea, vomiting, inappetence, refusal of medication, restlessness and discomfort? 

     

    < 25lbs $38.00

    26-50lbs $59.50

    51-90lbs $70.00

    > 91lbs $85.00

  • Please answer here for the Cerenia Pre Surgery Injection question above*

  • Pre- Anesthetic Blood Screening

    ***(Required for Pets 7 years and older)*** Blood screens alert doctors to any potential health problems while ensuring that your pet is healthy enough for anesthesia / surgery
  • For our mature patients (7 years & older) or any pets with chronic health problems, bloodwork must be completed prior to anesthesia and/or surgery. This testing will check your pet’s liver & kidney function as well as electrolyte, protein & glucose levels. Occasionally we postpone surgery until a medical problem is resolved. Alternatively, the anesthesia protocol may be changed to accommodate the pet’s medical needs. **The cost of this testing is $170***
  • Even for our healthy, younger patients (under 7 years old), pre-anesthetic blood testing, though not critical, is highly recommended to verify that organ function is normal prior to administering anesthesia. In rare occasions, problems are detected that change our plans. *The cost of testing for young patients is $160.***
  • My pet is under 7 years old and I want a blood screening.*
  • I want the following blood screen done on my pet:*
  • If your pet is coming in for a tumor removal, do you want a histopathology done on the mass? $185.00*
  • Consent for Extraction*

  • Authorization to proceed

    1) I authorize the use of appropriate anesthesia/medication and support the personal judgement of the Veterinarian. I understand even though every precaution is taken, anytime an animal is anesthetized there is a slight risk that an adverse reation could potentially occur resulting in death. 

    2) I understand during the above listed procedures an unforseen medical condition may become evident that necessitates an extension of or an addition to these procedures. I authorize the performance of such procedures as are perceived necessary in the professional judgement of the Veterinarian. 

    3) I understand that the result of any procedures/surgery can not be guaranteed.

     

    I am aware of the risks and understand the information presented in this consent form and I give authorization to proceed with procedures/surgery and perform any and all life saving procedures should the need arise.

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