Minor Surgery Form

Minor Surgery Form

Client Full Name

Surgery Consent Form

All of our elective surgeries now include: IV Catheter Placement, Induction using Propofol, Gas Anesthesia during the Procedure, An Injection of Pain Medication and Oral Pain Medication to be administered at home. Please read the following options.

PRE-ANESTHETIC LAB WORK

Your pet will be undergoing a surgical or dental procedure under sedation or general anesthesia today. In order to recognize any underlying abnormalities your pet may have, which may put them at a greater anesthetic risk, we recommend having a pre-anesthetic blood profile run on your pet. This consists of a CBC, which will check blood cells, and a chemistry panel, which will check blood glucose, protein, and kidney and liver function. These blood tests will help us to assess the health status of your pet more completely and determine if there are any additional precautions we need to take before surgery. If an unforeseen problem becomes apparent on the bloodwork, surgery/dentistry may not be performed at this time. If your pet has had bloodwork in the past 30 days, we will not need to repeat blood test today unless deemed necessary by the Veterinarian.
PRE-ANESTHETIC LAB WORK

FLUID THERAPY: IV CATHETERS ARE REQUIRED FOR ALL PATIENTS

Fluids are recommended to protect your pet's kidney and heart. Fluids shorten recovery time and help your pet feel better sooner. An IV catheter placement allows for IV fluid administration during and after surgery. This also provides us direct IV access in case of emergency.
Fluid Therapy

LASER SURGERY

Most surgical procedures can be done with laser. It offers less pain and bleeding, and a quicker recovery. The cost would be an additional fee $60.00 for one surgery and $100.00 for combined surgeries.
Laser Surgery

DENTAL

$250.00 covers just the cost of the teeth being scaled, polished, and dental radiographs. If any teeth need to be extracted, there will be a charge of $15.00 per tooth and $50.00 each surgical extraction.

COLD LASER THERAPY

The cold laser is used following surgery to stimulate the natural healing process so that your pet recovers more quickly.
Cold Laser Therapy

BATH

Would you like your pet to receive a bath before surgery? ($30.00) We offer a Deshedding Conditioner for an additional $15.00, Anal Gland Expression for an additional $20.00
Bath

MICROCHIPPING

According to statistics, one in three pets become lost at some point in their lives, and yours could very well be one of them. This is not a tracking device and pets with microchips are up to 20 times more likely to be reunited with their owners. It is a simple procedure where the chip is placed in between the shoulder blades. The chip then gets uploaded with your information so if your pet is lost and brought into a veterinary hospital or a shelter you can be reunited.
Microchipping

Total & Authorization

I understand the current estimate for today's procedure, this amount may change.
We will do our best to stay at or below your budget, but if unforeseen treatments are deemed necessary by the veterinarian and go over your budget listed, we will call you for authorization.
Name of owner or agent

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