Pre-Operative Consent Form

Pre-Operative Consent Form

At Advanced Veterinary Care, we are dedicated to providing high quality surgery and medicine to your special furry family member. We are happy to provide you with an estimate, if requested.

* Indicates required field

Pet's Name *

First

Last

Species *

Color *

Age/Birthday *

Date *

List all allergies to medications *

List any food allergies *

List any known medical conditions or concerns *

List any medications that your pet has taken in the last 2 weeks including supplements and over the counter products such as aspirin *

Microchips save the lives of many animals each year, allowing them to be safely re-united with their owners in the even of escape or natural disaster.

Would you like us to place a microchip in your pet while they are sedated? The cost is $92 *

A complimentary nail trim will be provided with any surgery.

*Pre-surgical blood-work is MANDATORY for surgical procedures and will be done at an ADDITIONAL CHARGE of $110

Growth Removal (indicate site/location) *

Other Procedure *

As the owner/agent of the above pet, I authorize to execute this consent *

I understand the risks of both surgery and anesthesia (including death) *

I authorize consent to perform the above indicated procedure(s) *

Owner/Agent electronic signature *

Date of consent *

Good contact number *

Submit

Microchips save the lives of many animals each year, allowing them to be safely re-united with their owners in the even of escape or natural disaster.

*A complimentary nail trim will be provided with any surgery.*

*Pre-surgical blood-work is MANDATORY for surgical procedures and will be done at an ADDITIONAL CHARGE of $110

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A complimentary nail trim will be provided with any surgery.