Welcome New Clients! Book today and get $40 off your first exam! *Terms Apply

Dental Treatment Consent Form

Good oral health is key to your pet’s well-being—fill out this form so we can provide the best care during their dental procedure.

Procedure(s)

CONTACT INFORMATION

Where can you be reached throughout the day in case of Emergency or the Doctor needs to discuss your pet condition

Recent Patient History

RECENT HISTORY- within the last 2 weeks

MEDICATION/ SUPP'S

List Medications
List Other Medications And Supplement

External Parasites

Pets found to have fleas or ticks upon presentation will be treated and charged accordingly

Pre-Anesthetic Bloodwork

Labwork appropriate to your pet's age and health status has been performed or will be performed prior to giving any medications.

For Cats Only

Anesthesia/Resuscitative directive

Extractions / Plaque Barrier Sealant

It is VERY important that you leave a contact number where you can be reached throughout your pet's stay.

Ancillary Procedures

Clear Signature

What is 4+4?

*This promotion is valid for new clients only and may be used once per client. Cannot be combined with other offers or promotions. Other restrictions may apply.