Please have your pet here between 8 am – 10 am in the morning of the surgery. Your pet should not have any food after 10 pm the night before; water is allowed! Please bring this completed form to check-in.
Your pet's safety and comfort are our number one concern here at Harrisburg Pike, LLC. Before your pet has surgery on date, he/she will be examined for any problems that could interfere with anesthesia and will be monitored after surgery to help ensure that your pet has a safe recovery.
Today, name of pet will be having surgical procedure performed.
*We require pre-anesthetic blood testing for pets 7 years or older, as well as for all electives, such as dentals and lumpectomies, etc. Please let us know is there is anything else your pet will need during their time here.
*Pre-anesthetic blood testing $49.95 — Yes blanks No blank
Post-surgery pain medication (prices vary) — Yes blanks No blank
Apply flouride to my pet's teeth $16.95 — Yes yes Nono
Home Again Microchip Identification System $59.95 — Yes blanks No (We will provide appropriate paperwork for HomeAgain & lifetime license to be sent into courthouse.)
Please clean my pet's teeth in addition to the procedure already being done $50.00 (does not include extractions) — Yes blanks No blank
blanks I grant Harrisburg Pike Animal Hospital, LLC and its employees the right to take photographs of my pet to copyright, use, and/or publish in print or electronically.
All pets are required to be current on their vaccinations, flea and worm free, and all cats are required to have had a FELV/FIV test. If needed, appropriate medications and/or procedures will be performed.
I hereby authorize Harrisburg Pike Animal Hospital, LLC to perform the procedure(s) noted above and to administer anesthetics or drugs seemed advisable for my pet. I understand the nature of the procedure(s) and relative risks involved for my pet. I authorize Harrisburg Pike Animal Hospital, LLC to provide any appropriate care should an unexpected complication arise.