Please complete this form before your surgical appointment.
Thank you for dropping off your pet with us today! The following information will be used to help our veterinary team accurately complete your pet's medical history for today's visit.
We will need to be able to contact you or someone with permission to make medical and financial decisions.
Please note: If your pet has fleas, they will be given a Capstar at your expense.
Blood Work & Additional Services
Please note: Pre-anesthetic blood work checks the internal organs and blood count and is a vital part of safe anesthesia. Help us provide the best level of care for your pet by choosing to perform blood work prior to anesthesia or sedation.
Full Chem, CBC, and Lytes - $110
**Note – Full bloodwork - an all major organs and full red and white blood cell count; indicated for longer anesthetic procedures and sick patients. **Required for pets over the age of 8 years old**. NOTE – We may require this blood work for some procedures and situations.**
**Required for pets over the age of 8 years old**.
NOTE – We may require this blood work for some procedures and situations.**
Partial Chem and CBC - $90
**Basic internal organ screen (liver, kidneys) with full red and white blood cell count; for generally healthy, younger patients.
*Required for pets over the age of 5 years old**
I, the owner/agent of the pet described above, hereby consent to and authorize the performance of such procedures and accept financial responsibility for any resulting additional charges. I understand my pet will be going home with pain medications prescribed by the veterinarian, and these medications are NOT optional.
I understand payment is due in full at the time of my pet's discharge and agree to be responsible for any and all charges incurred. If for any reason, my pet may need to be hospitalized overnight, I understand that I will be referred for overnight care at the Swansboro Emergency Hospital and that I will be responsible for the transportation of my pet.