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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
*
Canine
Feline
Other
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
*
Yes
No
*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
Procedure
*
Spay
Neuter
Dental Cleaning
Growth Removal
Other
Growth Removal (indicate site/location)
*
Other Procedure
*
As the owner/agent of the above pet, I authorize to execute this consent
*
Yes
No
I understand the risks of both surgery and anesthesia (including death)
*
Yes
No
I authorize consent to perform the above indicated procedure(s)
*
Yes
No
Owner/Agent electronic signature
*
Date of consent
*
Good contact number
*
Submit
Home
About
Staff
Veterinarians
Technician 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