Surgical and Dental Check-In Form

Pet Name:*

My pet is here for:*

Spay (extra charge for pregnant or "in heat" spays)

Neuter

Front Declaw

Back Declaw

Dental

Other

If you answered other, please specify:

Your pet is with us today for a procedure requiring anesthesia. Pre-operative lab work screens your pet for conditions that may not be evident on a physical examination. These tests are similar to those your physician would run were you to undergo anesthesia. We recommend this blood work for all anesthesia patients. To ensure that your pet is in a low-risk category for anesthesia, we will screen for diabetes, low sugar, anemia, dehydration, kidney disease, liver disease, and bleeding disorders.

The cost is $48. *

Accept

Decline

The cost is $95.*

Accept

Decline

The cost includes a post-operative injection and 3 days of medication.*

Accept

Decline

Are there any other services you'd like us to provide while your pet is under anesthesia?

Nail Trim

Express Anal Sacs

Ear Cleaning/Flushing

Histopath

E-Collar

Microchip

While anesthetized, we will perform a thorough oral/dental examination on your pet. We occasionally find teeth that require more extensive treatment due to advanced gum disease or open root canals. Teeth with open root canals (secondary to severe cavities or fractured teeth) or with extensive gum disease (50% of root damage) are initially painful and eventually become infected. Leaving a painful, infected tooth untreated is not a fair or safe option for your pet. We recommend you choose one of the following options:

Please select one of the options below:

Refer my pet to a veterinary dentist if the tooth can be repaired with periodontal surgery, root canal, or filling (estimated $200-$500 per tooth). If the tooth cannot be repaired, please remove it.

Surgical extraction (fee-based on surgical time and Root System).

If I cannot be contacted by phone to discuss treatment options, I prefer no extractions are performed during this dental procedure

Surgical and Dental Check-In Form

Pet Name:*

My pet is here for:*

If you answered other, please specify:

Pre-Op Bloodwork Consent

IV Catheter and IV Fluid:

The cost is $95.*

Post-Operative Pain Relief Medication

The cost includes a post-operative injection and 3 days of medication.*

Are there any other services you'd like us to provide while your pet is under anesthesia?

Dental Procedures