hoofandpawvet.com - Dental Form Front Desk

Dental Form Front Desk
PET NAME
CLIENT NAME
Drop off time is from 7-8 am on surgery day.
If you are unable to arrive in that time frame please let us know.
Hoof and Paw Pre-Surgical Paperwork

***Please leave us a phone number(s) where you can be reached the day of surgery***
Home Phone
Please enter a valid phone number.
Name
Cell Phone
Please enter a valid phone number.
Name
Work Phone
Please enter a valid phone number.
Name
Other Phone
Please enter a valid phone number.
Name
Email
example@example.com
Please read carefully and sign

Your pet is scheduled for surgery/anesthesia. We recommend a blood profile to ensure that your pet is in a low risk category prior to anesthesia. The latest technology has enabled us to run safe and accurate blood chemistries minutes before anesthesia induction. These tests are similar to those your own physician would run if you were to go under anesthesia. In addition, the results of these tests will serve as reference values for future use should your pet become ill. Please check one option and sign below.
Pre anesthetic bloodwork, healthy patients 6 mo to 6 years old - $80

Yes, I would like the recommended blood tests performedNo, I have elected to refuse the recommended blood work at this time and request that you proceed with anesthesia. I assume full financial responsibility for this animal and understand that there is always a risk with anesthesia.
REQUIRED for patients 7 years and over
- Pre-anesthetic bloodwork, 7 years and over - $98.00 (as of 3/15/2024)
Owner Signature

Clear
Date

MonthDayYear
Date

HOOF AND PAW DENTAL RELEASE FORM
Client Name
Date

MonthDayYear
Date
Patient Name
What to expect from today’s procedure:
- Full examination of gums, teeth, tongue and other soft tissues
- Anesthetized full mouth x-rays
- Dental scaling and polishing of all teeth (if not done in the last 6 months)
IF…your pet needs extractions or treatments we will call you!!!
After conducting the examination and x-rays, if your pet needs any extractions or
periodontal treatments we will attempt to call you to discuss options. However, if we cannot
contact someone authorized to approve treatments while your pet is under anesthesia
please indicate how you would like us to proceed below

Please wake my pet up from anesthesia without doing any treatments if you cannot reach me or authorized person for permissionPlease do all extractions and treatments necessary if they do not exceed the estimate provided previouslyPlease do any extractions and/or treatments needed despite costPlease do any extractions and/or treatments with dental that will not exceed a total cost for today of
$
Client Signature

Clear

Hoof and Paw Veterinary Clinic Microchip Form
1 in 3 pets will go missing during their lifetime

There’s no way to predict whether your pet will get lost. The local humane society is full of pets just like yours who’s owners were not found. Each year 8 to 10 million pets stray away from their homes - it is not just something that happens to certain types of pets or less attentive owners.

Losing a pet may be easier than you realize:
- Thunderstorms or fireworks can cause your pet to panic and flee
- Your pet could dig under a fence or bolt through an invisible fence and escape
- A child or handyman could accidentally let your pet out
- While traveling, your pet could wander into unfamiliar territory
- During an emergency your pet could get lost in the turmoil
Microchipping can help your pet find their way home if they become lost.
In the US, 90% of lost pets won’t return home without effective identification. Don’t let this happen to your pet - with microchips an animal shelter is 7 times more likely to find the owners of stray pets. A microchip is permanent identification, and unlike a collar cannot fall off or be removed. Microchipping is quick and can be done at any time.

Enrolling in the HomeAgain microchip registry is the best chance of a happy homecoming.
With HomeAgain, more than 850,000 lost pets have found their way home. Membership also includes additional benefits, such as:
- National lost pet recovery network
- 24/7 lost pet specialists
- Rapid lost pet alerts
- Personalized lost pet posters
- 24/7 emergency medical hotline
- Travel assistance for found pets
Would you like to have your pet microchipped today for just $46 (cost as of 3/1/2024)?

YesNo
HomeAgain Enrollment Form
Pet Name
CatDog
Pet Birthday

MonthDayYear
Date
Owner Name
Address
Phone Number
Please enter a valid phone number.
Email
example@example.com
Alternate Contact Information

Preferably someone outside of the household
Name
Phone Number
Please enter a valid phone number.
Should be Empty:

Dental Form Front Desk

Hoof and Paw Pre-Surgical Paperwork

Authorization for anesthesia and/or surgery and/or laser treatment

HOOF AND PAW DENTAL RELEASE FORM

Hoof and Paw Veterinary Clinic Microchip Form

HomeAgain Enrollment Form

Alternate Contact Information