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Pre-Operative Consent Form
At Advanced Veterinary Care, we are dedicated to providing high quality surgery and medicine for your special family member.
*
Indicates required field
Pet's Name
*
First
Last
Species
*
Canine
Feline
Other
Color
*
Age/Birthday
*
Date
*
Medical History:
Does your pet have any allergies to medications? If so, please list all medications.
*
Yes
No
Specify:
*
Does your pet have any food allergies? If so, please describe.
*
Yes
No
Specify:
*
Does your pet have any known medical conditions such as kidney disease, liver disease, e=heart disease, ect.?
*
Yes
No
Specify:
*
Please list any medications your pet is currently taking or has taken in the last two weeks, including over-the-counter products such as Benadryl.
*
No
Specify:
*
I would like a microchip placed in my pet while sedated. The additional cost of $96.00 is not included in surgery fee.
*
Yes
No
*A complimentary nail trim will be provided with any surgery.*
Is your cat an indoor cat?
*
Yes
No
**Type of pre-anesthetic used for surgery will be done at the doctors' discretion based on the needs of each individual pet.**
**Pre-anesthetic bloodwork will be done to evaluate the health of all small animals prior to surgery at an
ADDITIONAL COST. As the owner/agent, I authorize to execute this consent. I understand the risk of both surgery and anesthesia, and authorize consent to perform the following procedure(s):
Good contact number
*
Procedure
*
Spay
Neuter
Dental Cleaning
Growth Removal
Other
Specify:
*
Owner/Agent electronic signature
*
Date of consent
*
Submit
Home
About
Our Team
Veterinarians
Medical Team
Kennel Team
Reception Team
Administration Team
Services
Wellness
Diagnostics
Laser Therapy
Surgery & Dental
Boarding & Daycare
Forms
Survey
New Client Form-Veterinarian
Pre-Operative Consent Form
Contact
AVC Contact
Emergency and Urgent Care Information
Referrals
Online Store + Pharmacy
Pet Loss Support
Giving Back
FAQ
Careers