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Surgical Release

All Creatures Veterinary Hospital

Surgical Release Form

You may submit this form online or click here to print out form and return to office.

Required Fields


Email Date Owner's Name
Pet's Name
Does your pet have any problems that we need to be made aware of prior to surgery?


Occasional problems can arise due to pre-existing conditions of the liver and kidneys. To avoid these problems we recommend that your pet be screened upon admission by means of a blood test.
Would you like your pet to have pre-surgical bloodwork? ($75.00)


We recommend feline Leukemia/AIDS testing due to the increased number of infected cats found in our area.
Would you like your cat tested for Leukemia/AIDS? ($55.00)


We recommend heartworm testing and preventative due to the increased number of heartworm dogs found in our area.
Would you like your dog tested for heartworms? ($40.00)


It has been shown that the use of pain medication promotes faster healing and recovery. Therefore, in addition to anesthesia, pain medication is recommended for all surgical procedures.
Would you like your pet to receive a pain relief injection with surgery? ($23.50)


*Pain relief injections are automatically given with declaws which is included in the price of the declaw.


Would you like pain medication sent home with your pet?

If your pet is getting a dental today then we recommend getting the barrier sealant applied after the teeth are cleaned. This sealant helps protect the teeth and gums from plaque and calculus buildup due to bacteria. Therefore, there should be a longer period between dentals. After the sealant is applied here at the clinic you use the plaque prevention gel at home once a week. Would you like the dental sealant ($60.00)(includes 8 weeks of at home treatments)


Microchips are an excellent way to permanently identify your pet if he/she should ever become lost. Microchips are safe and effective, and can be placed quickly and painlessly.


Please check all that you would like done today:











FOR ALL SURGICAL PROCEDURES WHICH REQUIRE SUTURES WE STRONGLY RECOMMEND THAT YOU TAKE AN E-COLLAR HOME FOR YOUR PET. IF YOUR PET HAS TO COME BACK DUE TO LICKING OR CHEWING AT THE INCISION AND YOU HAVE CHOSEN NOT TO AN E-COLLAR YOU WILL BE RESPOSIBLE FOR ALL CHARGES. WOULD YOU LIKE AN E-COLLAR SENT HOME WITH YOUR PET TODAY? ($16.00)



For all surgical procedures, we require proof of rabies vaccination given by a licensed veterinarian.

If proof cannot be provided, the rabies vaccination will be given at your expense.


Additional fees of $25.00 will be charged for animals that are in heat or pregnant. If your pet is infested with fleas and ticks, it will be treated at your expense. If your pet is soiled upon arrival and needs bathing, it will be done at your expense.


Emergency Phone Number


How do you intend to pay?


Your Name Date