• Colorado Veterinary Specialty Group Canine Blood Donor Agreement

  • What we ask of our donors:

    1. The donor family agrees to particpate in the blood donor program for a minimum of one year unless the donor's health necessitates early retirement.
    2. The donor famiy agrees to notify Colorado Veterinary Specialty Group if the donor is taken outside of Colorado while particpating in the blood donor program.
    3. The donor family agrees to keep the donor current on all vaccinations (rabies and DA2PP within the last 3 years).
    4. To ensure the donor's optimum health, the family understands Colorado Veterinary Specialty Group needs to be notified of all medical conditions, changes in health status, and medications the donor is or was taking while enrolled in the blood donor program.
    5. Blood donors may need to be sedated for their dontions at no cost to the owner.

     What we will provide in return for your donation:

    1. An annual exam will be performed and full labwork, including a 4DX test (tests for 3 types of tick-borne diseases and heartworm disease), complete blood count, full chemistry panel, urinalysis (free catch sample is acceptable), fecal (if sample provided), and brucellosis testing is sent to a reference laboratory.  Results are reported back in 72 hours.
    2. The donor family is awarded $100 for every third donation.
    3. The donor family is awarded $75 per emergency call in.
    4. Patients will be eligible for a unit of blood at no cost if it is needed.
    5. A 10% discount on emergency services will be offered for active blood donors.
  • Colorado Veterinary Specialty Group agrees to provide all of the donor's medical information to the family's primary veterinarian in a timely manner.

     

  • Sedation Authorization

  • I authorize Colorado Veterinary Specialty Group to administer sedation to * for the purpose of blood donation. I understand some risks exist with sedation and anesthetic drugs and I am encouraged to discuss any concerns I have about those risks with the attending veterinarian or technician before the donation is performed. CVSG will keep records of medication dosages and anesthetic protocols for use during blood donation so the lowest dosages/safest protocols can be used including injectable and/or oral medications.

  • Pet's name
    *

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Should be Empty: