Dogs Spay or Neuter

Do you already have an appointment?
**If you do NOT have an appointment please request one now on our website**

Filling out this form does not mean your appointment has been scheduled. Your appointment must be confirmed by email. You must make the appointment in our pet portal https://petportal.vet/spaynow, you can also locate it in our website https://spaynow.com
PLEASE MAKE SURE YOU READ THE GENERAL INSTRUCTIONS WHICH IS LOCATED ON THE LINK TREE AND OUR WEBSITE
Owner's Name:

First NameLast Name
Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Email:
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Appointment Date:

MonthDayYear
Date
Animal's Name:
Microchip Number (if present/known):
Pet Breed:
Pet Color:
Gender :
Pet Age or Birthday:
Ex. 1/1/2024
Please mark all procedures to be performed today. For unlisted prices ask a receptionist:

Other
Scrotal ablation involves the complete removal of the scrotum to prevent swelling following a neuter. This type of procedure is more commonly used in dogs weighing over 50 pounds.
IV catheters and fluids are NOT INCLUDED in the price of spay/neuter surgeries except when deemed necessary. IV catheter and fluids are always recommended, particularly in older or sickly patients, but they are not required.
We always recommend pre-op bloodwork for all our patients. We do not have the ability to perform same day bloodwork. If you would like to receive pre-op bloodwork and your procedure is today, please speak with a receptionist about rescheduling your procedure. Pre-op bloodwork is not required.
Please read and sign:

Spay Now will provide postoperative surgical rechecks for our patients for no charge within 2 weeks of surgery during our regular clinic hours. If any medications are needed, there will be a nominal fee. Please call or email us (301-483-7080, spaynowsurgery@gmail.com) if you have any concerns after surgery. If you elect to take your pet elsewhere for post-operative care, we cannot reimburse you for any costs involved. If your pet is not currently on flea or tick prevention, there is a chance your pet may come into contact with animals also not on prevention and could contract fleas. In this event, I understand Spay Now is not at fault and that I may have to purchase flea/tick medication. I hereby declare that I am the owner, guardian, or responsible party for the animal listed above. I consent to and authorize Spay Now to perform the above listed procedures on my animal. I also consent for Spay Now to administer medications and/or ear cleaning, nail trimming, and/or grooming/bathing/matt removal as deemed necessary or prudent. While I expect these procedures to be performed to the best abilities of the veterinary and staff, I understand that with any vaccination, medication, anesthesia, or surgical procedure there are risks, including drug and vaccine reactions, bleeding, infection, or anesthetic complications up to and including death. I expect that reasonable precautions will be used to ensure the animal’s safety and well-being while in Spay Now’s care. I agree to release and hold harmless Spay Now, its agents, employees, and volunteers from all actions, causes of action, damages, claims or demands, which I, my heirs, executors, administrators, or assigns or the animal’s owner may have against the above referenced releases, for any and all damages, causes, or actions and injuries known or unknown, which may arise as a result of the surgery or treatment received by my animals. I have read and agree to the above:
Signature
Date

MonthDayYear
Date
Is your pet currently having any health problems?
If yes, please describe:
Has your pet seen a vet recently for any health problems?
If yes, what was the diagnosis:
Is your pet taking any medications at this time?
If yes, list what medication(s) and approximately how many days of it do you have remaining:
Is your pet taking any sort of steroid (prednisone, prednisolone, depo-medrol, etc) or NSAID (carpfrofen, rimadyl deramaxx, meloxicam, meloxidyl, etc) medication?
Are you able to make your pet take pill medications even if they do not want to take it?
Has your dog had any previous litters, c-sections, or other surgeries?
If yes, please list:
Is there any chance your dog could be pregnant*?
Has your dog ever had or are they currently having any of the following (circle all that apply):
Please explain any marked above options:
Do you have any concerns about your pet? If so, please list:
With owner consent, certain procedures are recorded to be used as a training example for other doctors. They are not posted on any social media or freely available platform. Are you willing to consent to have your animal’s procedure recorded and stored internally?
At Spay Now, our top priority is the safety and well-being of our patients and our staff members. Some dogs, particularly those who are very fearful, anxious, or aggressive, may require special medications to allow for safe examination, handling, or treatment. With your signature, you acknowledge that Spay Now is authorized to use an Aggressive/Reactive Dog Protocol ($50 - $100) for your pet, if the veterinarian deems it necessary.
By signing below, I understand Spay Now closes at 4 p.m. The latest time you can pick-up your animal is 3:30 p.m. At 3:30 p.m. clients who have not arrived are charged with a late fee of $50, and charged $25 for every 15 minutes they are late after 3:30 p.m. With your signature, you acknowledge that you have read and understood our late fee policy, and will be responsible for arranging transport for your pet in a timely manner.
Cryptorchid Acknowledgment (Male Pets Only) I understand that if my male pet is found to have one or more retained testicles (cryptorchid) at the time of surgery, and Spay Now is unable to reach me, I authorize the veterinarian to proceed with removal of the retained testicle(s).I understand that additional fees apply and agree to pay these charges at the time of pick-up.• Inguinal Cryptorchid : $70 per testicle• Abdominal Cryptorchid: $135 per testicle
Should be Empty: