LCHS Spay & Neuter Consent Form

Spay and Neuter Prices:
Male Cat $50
Female Cat $60
Dogs: Please realize that we will be weighing your dog before the surgery to get the proper weight.
Female Dogs 0 to 25 lbs $70
Female Dogs 26 to 50lbs $80
Female Dogs 50lbs to 75lbs $90
Female Dogs 75lbs to 100lbs $105
Female Dogs over 100lbs $160

Male Dogs 0 to 25 lbs $65
Male Dogs 25 to 50lbs $70
Male Dogs 50 to 75lbs $75
Male Dogs 75lbs to 100lbs $80
Male Dogs over 100lbs $110

Pain medication to go home is an additional $8 for dogs and $15 for cats.

If your pet is pregnant, there may be an upcharge for the spay. For cats, it will be $10 for cats and $24 for dogs.
Laurens County Humane Society Spay & Neuter Consent Form
Please fill out a seperate form for each pet. We will need pet specific information, and it can get confusing with more than one pet on a form. Thank you!.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Pets Name*
Pets age or estimated Date of Birth *
Pets Sex*

MaleFemale
Pets Specie*

CanineFeline
Pets Breed*
Pets Coat Color*
Pets Weight*
Current proof of Rabies vaccinations are required for all pets treated at LCHS. If your pet has been vaccinated at another location, you must bring proof of vaccination when you drop off your pet. If not, your pet must receive their vaccination during their appointment.*

My pet has received their vaccine at LCHS Chips and TipsMy pet received their vaccine elsewhere, I will bring proof to registrationMy pet has not had a rabies vaccination, please vaccinate my pet for Rabies. I agree to any additional charge for this service.
Is your pet due for any of the following? Click on what you would also like to have done today. Additional charges will be due at time of discharge:*

DHPP (dogs) $15Bordatella (dogs) $12FVRCP (cats) $12FELv (cats)- $25Felv & FIV combo test- $30Heartworm Test- $14Heartworm Prevention- 1 month- $10Flea/Tick Prevention- 1 month- $20 for dogs $10 for catsDewormer- $5Microchip- $20No, I decline all extra optionsI am unsure what my pets needs, and would like to discuss this at check in
Heartworm Testing and Prevention is Extremely Important for your dogs health and well being. Annual testing is necessary, even when dogs are on heartworm prevention year-round, to ensure that the prevention program is working. Heartworm medications are highly effective, but dogs can still become infected. If you miss just one dose of a monthly medication—or give it late—it can leave your dog unprotected. Even if you give the medication as recommended, your dog may spit out or vomit a heartworm pill—or rub off a topical medication. Heartworm preventives are highly effective, but not 100 percent effective. If you don’t get your dog test, you won’t know your dog needs treatment.
Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) are serious infections that weaken a cat's immune system. FeLV is highly contagious and can cause severe illness, while FIV affects immune function over time. These diseases can be passed from a mother cat to its' kitten or by contact with an infected cat (via saliva, shared bowls, fight wounds, etc A FeLV/FIV combo test is recommended for all new cats, kittens, sick cats, or those exposed to unknown or positive-status cats. Testing should always be done before administering the FeLV vaccine. The FeLV vaccine is strongly recommended for kittens and at-risk cats, such as those who may go outdoors or live in multi-cat environments.
E Collars are recommended for after surgery care. If provided by us, it will be an additional $20. Would you like for us to provide you with an E Collar?

Yes, please provideNo
Tattoos for Spay/Neuter procedures - Tattoos are an additional method of identifying that your pet has been spayed/neutered. This procedure is non-painful, free of charge, and a required part of our process.*

I have read and understand the requirement of the tattoo
Has your pet been diagnosed with any major or chronic health conditions If so please list here*
Please list ANY AND ALL medications, supplements, or topical treatments your pet has received in the past 72 hours and WHEN they were last given:*
In the event that your pet codes in our facility, which advanced directive would you prefer our staff to perform*

CPR- Life Saving MeasuresDNR- Do Not Resuscitate
I authorize the use of appropriate anesthesia and /or pain relief medication(s) as needed before or after this procedure. I have been informed that there are risks associated with the use of any anesthetic or medication.*

I agree
With my signature on this document I am agreeing to the follow:

I agree to indemnify and hold LCHS, its' Doctors and/or staff, harmless from and against any and all liability arising from this procedure(s

I understand that Hospital Support Staff will be used as deemed necessary by the Veterinarian.

The nature of this procedure(s) has been explained to me, and I understand what the anticipated outcome should be. I have also been informed that there are certain risks and complications associated with any operation or procedure of this nature. I understand that the practice of Veterinary Medicine and surgery is not an exact science, therefore, reputable Veterinarians cannot guarantee any specific results. Even with extreme care, rare, adverse reactions which are unpredictable, may occur. Risks with anesthesia and surgical procedures include but are not limited to: cardiac arrest, respiratory arrest, bleeding, infection and/or death. I further understand that unforeseen complications may arise as a result of this procedure.

I understand that LCHS is not a 24 hour facility and there will not be 24 hour attendance to my pet

I understand that I will be required to pay any charges incurred upon discharge of my pet. I further understand that a deposit may be required prior to my pet's procedure(s)

I am the owner or the agent for the owner of the animal described above, and I have the authority to execute this consent. I hereby consent and authorize the staff of Laurens County Humane Society to perform the selected procedure(s) or operations on the above mentioned pet
Signature*

Clear
By clicking the submit button I agree that I have read and consent to Laurens County Humane Society's Terms Conditions
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Laurens County Humane Society Spay & Neuter Consent Form