Surgery Authorization Form

Owner Name(Required)

MM slash DD slash YYYY

Surgery Authorization

I hereby authorize performance of the above surgical procedure, including placement of an IV catheter and pre-anesthetic bloodwork. The nature of this procedure has been explained to my satisfaction and I realize that no guarantee or warranty can be made regarding the results or cure, and that all procedures involving general anesthesia carry a very small risk of complications including death. If becomes stressed during the blood draw or catheter placement I authorize the Doctors to administer sedation, at no additional cost, to allow catheter placement and a blood draw prior to the procedure. I understand that I assume financial responsibility for all services rendered and that payment is due on the date of surgery.Pre-anesthetic bloodwork may be run up to one week in advance of a procedure, or at the Doctor’s discretion.

Laser surgery results in less pain, less bleeding, less swelling, reduced risk of infection and faster return to normal activities. This is the same laser technology used in human surgery.


Every two seconds a family pet is lost. Many are never reunited with their families because they cannot be identified. Because of these statistics, we suggest microchips whenever a pet is sedated. HomeAgainchips are known nationwide and have a 24-hour hot-line to match chip numbers with owner’s contact information. The cost of microchip implantation is $61.50
Microchip Implant

Parasite control for the protection of all our patients, any pet left for treatment will be inspected for external parasites (fleas, ticks, ear mites, etc.).

If parasites are found, we will apply the appropriate topical treatment at the single-dose price.