*Pet(s) must be current on vaccinations or they will be given at the owner’s expense.

I consent to the following vaccinations to be given:

Rabies DHLP Parvo Bordetella FVR CP Feline Leukemia
I have not given my pet any food or water after midnight on the night before the procedure.

PRE-ANESTHETIC BLOODWORK RECOMMENDATIONS (additional charges will be applied-please mark yes or no)
Our greatest concern is the well-being of your pet. We will perform a physical examination before administering anesthesia. However, disorders of the liver, kidneys, or blood, are not detected unless blood testing is done. Abnormalities of any of these may increase anesthetic risk. For these reasons we highly recommend pre-anesthetic blood screens, especially for geriatric patients greater than 7 years old.

Yes No
Yes No
Yes No

ADDITIONAL OPTIONAL SERVICES (additional charges will be applied)

Nail Trim Express Anal Glands
Fecal HomeAgain Microchip Identification
Cold Laser Therapy reduces post-operative pain and swelling at the incision and can speed recovery $10.00

AUTHORIZATION TO PERFORM SURGERY
I here by authorize FAC to perform such diagnostic and surgical procedures as described above. I understand that there are rare complications associated with any anesthetic or surgical procedure. No warranty or guarantee has been given to me as to the results or cure afforded by these treatments or procedures. I understand that I assume financial responsibility for all services rendered and agree to pay all charges (including boarding costs) upon release of pet from the clinic.

I do not want my cat or dog spayed if she is pregnant. I have read and fully understand this surgery and anesthesia consent form.
Yes No

QUESTIONS?

If you have any other questions, please contact us.