• Hometown's Helping Hand

    Discounted Feline Spay Estimate and Surgery Authorization Form
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  • Client Information

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  • Please fill out the information below if you are planning on writing a check.  Driver's License or Social Security Number

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  • Pet Information


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  • Feline Spay Estimate

  • Please check all the boxes below of the services you are authorizing.  

    All Items that say "FREE" are included in surgery automatically.

    Please note that all additional items are at a discounted price and only good for the day of surgery.

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                                                • Pre-Surgery Blood Work Authorization

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                                                • Authorization To Perform Surgery

                                                  Please read carefully and sign:
                                                •      I hereby authorize the admitting veterinarian to administer such treatment(s) as is necessary to perform the above-mentioned surgery as well as additional services.

                                                        I understand that there may be a risk involved in these procedurres.  I consent to the administration of such anesthetic as are necessary.

                                                       Anesthetic Risks:  (Although every effort is made to make anesthesia as safe as possible including vital sign monitory and use of the most up to date anesthetic agents and equipment, understand that anesthesia has inherent risks).  The incidence of complications from anesthesia is extremely low and we do not anticipate any in your pet, but on rare occasion the following can occur:  1)  Allergic reaction to the anesthetic agents  2.  Heart rhythm abnormalities  3.  Untoward reactions to the gas including drops in blood pressure or respiratory difficulties  4.  Just like in humans, on very rare occations, general anethesia can result in death.  

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