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Cat Spay or Neuter Form
Please fill out all of the information on this form.
Did you already have an appointment?
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Yes, I have received a confirmation for my appointment
No, I have NOT requested an appointment through online
**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, only when your appointment is 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
Owners Name:
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First Name
Last Name
Phone Number:
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Please enter a valid phone number.
Format: (000) 000-0000.
Email:
*
example@example.com
Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Appointment Date:
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Month
-
Day
Year
Date
Animal's Name:
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Double-click to edit this text..
Microchip Number (if present/known):
Cat Status
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Please Select
Indoor Only
Indoor and Outdoor
Outdoor but friendly
Feral (not friendly)
Cat Breed (DSH, DMH, DLH, Other (please specify)
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Pet Color:
Sex:
Please Select
Male
Female
Pet Age or Birthday:
Ex: 10/10/24 , 3 years or 2 months
Please mark all procedures to be performed today. For unlisted prices ask a receptionist:
Spay/Neuter $85-220
Rabies vaccine $20 (if proof of rabies vaccination has not been provided, this will be added)
FVRCP Vaccine ($15)
Deworming ($8)
Microchipping ($45)
Flea Meds (in-house) ($7)
Ear Cleaning ($10)
Nail Trim ($10)
Umbilical hernia repair ($60)
FeLV/FIV Test ($45)
Ear Tip
Other
With owner consent, Spay Now records specific procedures for other doctors to use for training purposes. Photos are also captured pre and post-operation for our social media accounts. Do you authorize Spay Now to document your animal's stay for internal and external use?
*
Please Select
Yes, I consent to photos
NO, I do not consent to photos
Please read and sign:
Spay Now will provide postoperative surgical rechecks for our patients for no charge 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
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Date
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Month
-
Day
Year
Date
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. Keep in mind if you have multiple pets, the late fee is per animal. 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.
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