• Low Cost Spay/Neuter Application

    Low Cost Spay/Neuter Application

  • Qualifications for our Low Cost Program are as follows:

    • Must be at least 8 weeks (or 2 lbs)
    • Must be under 12 months of age
    • Must weigh less than 50 lbs
    • Must be in healthy condition
    • Must be fully vaccinated, including all boosters, at least one week prior to surgery
    • Female dogs CANNOT be in heat.

    Required vaccines:

    Dogs - Rabies, Canine Distemper, Bordetella, Canine Influenza

    Cats - Rabies, Feline Distemper

    **Application must be submitted AND approved prior to scheduling**

  • Canine Services

    The following services are available for DOGS ONLY.
  • *Must be over 7 months of age

    **Testing of liver/kidney functions before surgery

    ***This helps keeps the patient hydrated during surgery

     

  • Feline Services

    The following services are available for CATS ONLY.
  • *Must have test prior to vaccine

    **Testing of liver/kidney functions before surgery

    ***For female cats only - keeps them hydrated during surgery

  • Patient History

  • If your pet happens to be pregnant at the time of surgery, we can still go forth with the spay. There will be an additional charge of $7.25/minute plus additional anesthesia time (up to $85).

  • Please carefully read and understand the following before signing

  • I hereby certify I am the owner or authorized agent of the owner, of the animal, and I give Belmont Veterinary Center full authority to perform a surgical spay/neuter, or other surgical procedures on said animal. I hereby release Belmont Veterinary Center from any and all liability arising from said surgery, adverse reactions, or unforeseeable events. I understand and accept, although rare, there are inherent risks, including death, involved with any anesthetic and surgical procedure.

    **Full payment is due at the time of drop-off**

    • In case of emergency, I authorize Belmont Veterinary Center staff to perform any procedure deemed necessary to save my pet. 
    • I certify that my pet has been vaccinated within one week prior to this date and understand that they are not protected from contagious diseases. I understand that it takes up to two weeks for vaccinations to protect my pet. Belmont Veterinary Center has the right to refuse service to any animal to whom surgery is deemed a health risk. 
    • I understand that if I do not pick my pet up from surgery before 6pm on the day of surgery that I will be charged an overnight boarding fee. 
    • I understand that if my pet stays over night there will be no staff on premises 24 hours a day to monitor my pet. 
    • I understand if my pet has fleas it will be given a prevention in house to kill all the fleas and prevent them from spreading. The fee for this service is $35. 
    • I understand that take-home pain medication is not optional for my dog (cat owners may elect take home meds if they would like, but its not required for cats). The cost for these medications is $26
    • I understand that there will be a $22 pre-surgical exam charge
    • I understand that Cerenia, an anti-nausea injection, will be given to my pet at my expense. The cost for this is: $30.50 (under 30lbs) & $44.50 (31-50lbs)

    **Belmont Veterinary Center uses qualified staff and approved equipment and materials for for all procedures performed. It is important to understand that the risk of injury or death, although extremely low, is always present just as it is for humans undergoing surgery.**

  • Clear
  • Should be Empty:
Jotform Logo
Now create your own Jotform - It's free!Create your own Jotform