Pre-anesthesia blood testing: Most pets that undergo anesthetic procedures recover without incident. Our greatest concern is your pet's wellbeing. Our staff will take every precaution to ensure that your pet is safe under anesthesia. We use the safest anesthesia protocols; state of the art monitoring equipment and our staff is continuously monitoring your pet while under anesthesia. We require blood work for all pets 7 years of age or older, and pets with preexisting conditions, but we recommend it for all patients. Geriatric patients (those over the age of 7) blood work is mandatory, and that profile is $107.31. Those patients under the age of 7, blood work will be an extra $85.90.

Yes, please complete the recommended blood work for my pet prior to the procedure. If abnormalities are discovered, we will call you to discuss the results.
No, I have decided to decline the recommended blood work. I understand the risks involved and request that you proceed with the dental.

Consent to perform dental x-rays: We recommend full mouth dental x-rays for all pets. This allows us to look for problems under the gum line. Costs for dental x-rays are Cats $82.50, Dogs $95.50. Please check one option below.

I give consent to perform full mouth dental x-rays for the price listed above.
I decline having full mouth dental x-rays on my pet today. I understand that if extractions are performed, individual x-rays may be taken for $38.50 per x-ray to ensure the tooth was fully extracted.

Consent to perform dental extractions as needed. Please choose ONE option below.

Please perform any extractions necessary. I understand that extractions can sometimes take considerable time, involving gum and bone surgery. We will make every effort to get them done today, but if there are multiple extractions they may not get done today and your pet may have come back to complete the recommended procedure. I understand that my pet will be started on antibiotics and pain medication if the Dr. deems necessary. I assume full financial responsibility.
Call me after the initial assessment under anesthesia and provide an estimate of additional procedures. Do not proceed without authorization. You can reach me at the number below. I understand that if I cannot be reached at this number no extractions will be performed and I assume all responsibility for any complications this decision may cause my pet.

Misc. Services: While your pet is under anesthesia it can be convenient to perform some of these procedures. Please check the procedures that you would like performed.

Nail Trim (Complimentary)
Update Vaccines
Heartworm testing $44.10/ Feline Leukemia, FIV testing $57.98.

I agree to everything above and give my permission for Cottonwood Veterinary Clinic to perform this procedure.

How do you intend to pay for today's services?

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Notes to the Team about your pet's appointment:

Print Name

Signature *

Clear Signature

Date *

Phone Number *

Email *

Dental Consent Form

Dental Consent Form

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