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Surgery Release Form

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    Release Form



    All Services Must Be Paid For When Is Released. All Procedures Require Payment To Be Made Before Surgery. I agree to pay, in full, for services rendered, including those deemed necessary for medical or surgical complications or unforeseen circumstances. Any estimates or charges for the planned procedures are only approximations, and the final bill may be greater or less than these amounts


    We recommend that pre-anesthetic blood tests be performed prior to the administration of anesthesia. These tests can help us detect anemia, dehydration, diabetes, kidney disease and liver disease. All these conditions can contribute to complications in anesthesia and surgery


    I understand and would like my pet to have blood work as an added method of safety and accept the additional cost:
    I also understand that x-rays are recommended prior to surgery as well as an additional cost and I would like to:
    Urinalysis
    Release Date
    Phone number(s) where you can be reached