Spay/Neuter Authorization Form

Price includes the costs for the procedure, anesthesia, IV catheter and fluids, pain injection, pain medications for at home and medical collar to prevent licking at the incision site and creating an infection while the site is healing.

*Indicates Required Field

Pet Owner Information:

Owner's Name*

Best Number to Reach You By Number*

Owner's Email*

Pet Information:

Pet's Name*

Pet's Sex*
SelectMaleFemale

Species*

Pet's Breed*

Pet's Age*

PREOPERATIVE BLOODOWORK: PREOPERATIVE BLOODOWORK: We recommend a pre-anesthetic blood chemistry screen on all pets prior to anesthesia. Most anesthetic drugs are removed from the body by the liver and kidneys, therefore it is important that these organs are healthy. Underlying conditions are those where clinical signs are not apparent but problems could occur when anesthesia is performed. The tests include a complete blood count and serum chemistries profile. The additional cost for this full CBC/Chemistry panel is $132. Would you like us to perform pre-operative bloodwork on your pet?*
YesNo

PAIN MANAGEMENT PACKAGE: The upgraded pain management package includes an additional pain injection and medications to go home. This package costs $49.*
YesNo

LASER TREATMENT: Post Surgical Laser Treatment stimulates healing within target tissue, reduces pain and inflammation on post surgical incisions. Laser treatment costs $12.*
YesNo

OPTIONAL PROCEDURES

These procedures can be done under anesthesia. Please let us know which one you would like.

Microchip implantation, plus registration. Costs $50
YesNo

Ear Flush/cleaning. Costs $42.
YesNo

I understand that reasonable precautions will be used against injury, escape and death of my pet. All anesthetics do present a risk to the health and life of my pet. I accept these risks as part of the procedure. I realize that results cannot be guaranteed, and that payment in full is due at time of discharge. By signing below, I indicate that I understand and do agree to the above information.*

Client Signature*

Today's Date*