Surgery Check-In Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Surgery Check-In Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Click here to download the surgery check-in form hard copy.

Surgery Check-In

For Cat

Please Select Current /Update

For Dog

Please Select Current /Update

Owner authorization and release

All patients must have current PRE-ANESTHETIC blood screening prior to anesthesia per Doctor recommendations.

If your pet comes in with FLEAS we will administer treatment at the cost of $10.00

The nature and purpose of these procedures and treatments and available alternative treatments have been explained to me. I understand that anesthesia and surgery always involve some risk to my pet (such as unknown internal physical abnormalities, medication allergies, surgical complications, internal bleeding, shock, incision dehiscence, and post-surgical infections): and agree to hold you harmless, in the absence of negligence, in connection with these procedures. I understand that I will be held financially responsible for any veterinary medical care necessitated by these complications. I acknowledge that no guarantee or assurance has been made to me as to the results that may be obtained. In the event that complications arise and I cannot be immediately contacted at the below listed phone number, you are directed to make the decision you deem best for my pet. I consent to the administration of sedatives, analgesics, and anesthetic agents as deemed appropriate by the veterinarian in charge. I agree to pay for services rendered.
Clear Signature