Surgical Booking Form

Please be patient as we need time to book your appointment. If you haven't heard back from us within 7 business days, check your junk/spam folder for a message. Then if you still have not received an appointment AND you did sent your appointment holding fee, please call us at 519-869-4228. FORMS ARE NOT PROCESSED WITHOUT PAYMENT.

Pricing as follows:

Male Cat:$150 +HST
Female Cat:$250 + HST

Male Dog:$400 + HST
Female Dog:$500 + HST

Dogs over 7 years old—price may vary. You will receive a phone call from our office in regards to pricing.

Undescended testicles in dogs and cats—price may vary. You will receive a phone call from our office in regards to pricing.

Complimentary with surgery: vaccines, post surgery e-collar, nail trim, topical flea treatment and microchip (you will be able to select which of these you want for your pet further down the page).

A microchip is provided free of charge and is mandatory if your pet is not already chipped. Do you consent to your pet receiving a microchip? We will scan your pet the day of surgery to ensure they have a microchip if that option is selected.*

Yes.My pet is already microchipped.

To register a microchip, we require a primary and secondary contact name and phone number. In the box below, please provide a SECONDARY contact name and phone number (you will be the primary contact).

Have you previously registered a pet at this clinic?*

YesNo

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Pet Information (one form per animal)*

Male CatFemale CatMale DogFemale Dog

Pet Name*

Pet Breed*

Pet Colour*

Pet Age or Date of Birth*

Pet Weight*

Best estimate in pounds

Regular Veterinarian and Clinic

Should my regular veterinarian request my files, I consent to them being forwarded.

YesNoNo regular veterinarian

The following services are complimentary (free of charge) to your pet while here for surgery. Would you like your pet to receive any of the following services?

Rabies Vaccine (if declined, proof of rabies must be provided, upload proof of rabies below or email to animalhospitalbrightsgrove@gmail.com) (pet must be a minimum of 12 weeks of age to receive a rabies vaccination)Core Vaccines (DAPP for dogs, FVRCP for cats)Nail TrimTopical flea treatment (1 dose)

File Upload--Rabies Certificate

The following services can be completed at the time of surgery, if requested, at an additional cost.

Bordetella (Kennel Cough) Vaccine $45+HSTLepto Vaccine (requires booster in 1 month if first time receiving) $50+HSTHeartworm Test (tests for heartworm, lyme and other tick borne diseases)

For more information about Leptospirosis in dogs, please click the below link:

Leptospirosis in Dogs - Veterinary Partner

An E-Collar is provided free of charge for post surgery recovery. Or, you may purchase a medical pet shirt at an additional fee.*

Complimentary E-CollarPurchase medical pet shirt ($50+HST)I already have an e-collar or pet recovery suit at home.

Would you like to purchase additional flea/tick/dewormer products for your pet? If you click yes below, a list of products and prices will be emailed to you.

YesNo

Anticipated timeline, based on availability:

I can come in the next few days if there has been a cancellationwithin 7 to 14 dayswithin 15 to 30 days31 to 60 days

I would prefer an appointment on:

For MALE dogs and cats only--can you see and feel 2 testicles (lift the tail and look for 2 fuzzy marbles)

No (retained), we will call you before booking your appointmentYes

For FEMALE dogs only--has your female dog had puppies?

NoYes (mature)

Please read carefully the following information. Should you have any questions, please call the clinic or visit our website for answers to most commonly asked questions*

I understand a $75 non refundable appointment holding fee, for each pet, is required in order to book an appointment.I understand that if my appointment holding fee does not accompany my form, my booking will NOT be processed.My appointment holding fee has been sent to bgah@bgah.com by etransferMy name and phone number are on my e-transfer information and match this form.I understand that my appointment CAN be moved and my appointment holding fee follows that appointment with a minimum of 48 hours notice.I understand that Bright's Grove Animal Hospital does not have emergency or after hours care. Any assistance out of business hours is at my cost (the owner of the pet) and will not be refunded by BGAH.

Please list all current medications and any additional notes for staff: