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Name
Address
Alternative Contact
How did you hear about us?

Pet Information

I understand that there is an exam fee that does not include the treatment of my pet. I assume responsibility for all charges incurred in the care of my pet. I also understand these charges will be paid at the time of release and a deposit may be required on all hospitalized pets.
Procedure Type

Owner Name
Consent
Dental Agreement
We are committed to the safest anesthesia for all our patients. Problems can arise because of preexisting liver, kidney or blood conditions that may not be detected during physical exam. For this reason, we recommend blood tests to help provide reasonable assurance of the lowest possible risk for your pet.
The information also serves as a baseline that we can refer to in years to come.
Check one of the options below:
Please check any additional services you would like performed while your pet is under anesthesia:
Additional fees will apply for additional services selected.
Owner Name
Address

Pet Information

Please list medication name, and what times per day it should be administered to your pet.
Items brought with pet
All pets are required to be up to date on their Rabies and dogs require a Bordetella (or Kennel Cough vaccine) as well.
I authorize Abraham Veterinary Clinic to perform any procedures necessary for treating and maintaining my pet’s health and well being, while boarding here.
While I expect all procedures to be performed to the best of the staff’s abilities, I realize the hospital makes no guarantee or warranty regarding the results. I understand there is a risk to many procedures, including anesthesia.
If my pet should injure itself, escape, fail to eat, become ill, or die, I do not hold Abraham Veterinary Clinic and its employees responsible.
Payment is required at the time of the animal(s) release from our care. The pet(s) are released only during regular doctor’s hours.
Owner's Name

Symptoms

After doctor’s exam, may we do preliminary bloodwork, urinalysis, SEDATE , and/or X-ray?

Diabetic pets. Please have your owner answer the following:

Did you bring your own supply of insulin

Pets on Medication at Home. Please have owner answer the following

Pick Up Method
MM slash DD slash YYYY
DROP- OFF- Please drop off your pet between 7:30-8:30 am PICK UP: The doctor will call you after your pet is awake to let you know how he or she is doing. At this time they can often tell you when your pet will be awake enough to go home. Most pets are ready to go home between 3:30 4:30 pm, but please call before you come if you are not given a pick-up time. All pets must be picked up before 5:30 when we close.
THE NIGHT BEFORE: Please withhold food after 10 p.m. the night before the procedure, and do not feed the morning of the procedure. You can give water overnight.
ANTIBIOTICS for the dental should be started 4 days prior to the scheduled dental.
You DO NOT need to give any medications the day of the procedure, your pet will receive an antibiotic injection. Continue the next day with the medication and finish out your script as per instructions.

PRE ANESTHESIA BLOODWORK

Your pet will soon be undergoing a procedure that requires anesthesia. We are committed to making anesthesia for your pet as safe as possible. There are some risks with anesthesia, but these increase with age and can be further minimized by doing preanesthetic bloodwork to screen for infection, anemia, and dehydration, as well as preexisting liver, kidney, or blood problems. For young animals, this information can serve as a valuable baseline that can be used for comparison in years to come. If a problem shows up, we can delay the procedure, or alter the anesthetic medications we use to ensure your pets health and minimize risk.
We offer two levels of bloodwork as a pre-anesthetic screen:
- Level one includes an abbreviated profile of liver and kidney enzymes and blood sugar level, a complete blood count, and electrolytes (blood salts).
-Level two consists of a more inclusive panel of enzymes, a complete blood count, and electrolyte measurement.
The doctor may recommend which panel will be best for your pet.
If you have any further questions, please feel free to give us a call at 512-472-5879.
Visit our website at www.austinpetdoctor and enter the keyword anesthesia or the name of the procedure for more information.