Desexing Surgery Consent Form Please complete the following details. Desexing Surgery Consent FormWhich Clinic are your visiting? Pymble Killara Patient & Customer DetailsPatient NamePatient Weight TodayCustomer Name First Last AddressPhoneAlternate Contact No. if different for today:InsuranceDo you have Pet Insurance? Yes No If you wish to claim for today please let a nurse or receptionist know and we can submit it electronically for you.Would you like us to make GAP claim for you? Yes No Insurance ProviderInsurance Policy NumberQuestionsWhen was your pet last fed?When were your pet's Vaccines last done?How is your pet today? Any recent ailments we should be aware of? Please tell the nurse if so.Does your pet have any baby teeth remaining? Yes No Unsure - Please check Does your pet have hind dew claws that need to be removed today? Yes No Unsure - Please check Does your pet have an umbilical hernia that needs to be repaired today? Yes No Unsure - Please check Is your pet up to date with tick/flea treatments? Yes No Unsure Please list any other medications your pet is on? Add RemoveWhen was the last dose given?Here at the village vet we take every surgery seriously IV fluids: You can feel comforted knowing that all our patients are treated as required with intra-operative fluids. This allows excellent maintenance of blood pressure throughout the anaesthetic and replaces any fluid or electrolyte loss due to bleeding, sickness or dehydration. It makes every anaesthetic safer and every pets recovery more pleasant. Our patients go home far less affected by the anaesthetic drugs when they have been rehydrated peri-operatively. Pain relief: Patients require appropriate pain relief during and after surgery. Your pet will receive appropriate pain relief as part of their stay in hospital today. Your vet may send your pet home with additional medication today if necessary.Should your pet have any adverse reactions to anti-inflammatories of any kind that you know of please make us aware. Our vets highly recommend blood-testing prior to this procedure today for several reasons: To allow us to choose most appropriate fluid therapy today as indicated by the blood test. This may mean replacing electrolytes and fluids due to blood loss, dehydration or illness. We can also supplement the fluid with glucose if required. To give us an evaluation of organ function. The kidney and liver are responsible for breaking down the anaesthetic and are the first organs to be adversely affected by anaesthesia. We also run a CBC (complete blood count) which gives us valuable information about inflammation, clotting ability, anaemias and immune function. Chronic low grade anaemias are sometimes the first markers of disease and can easily go unnoticed. In addition to organ evaluation and the CBC, the calcium level can act as a marker of early cancer and other disorders. Should your pet have any adverse reactions to anti-inflammatories of any kind that you know of please make us aware.Blood test approval Yes - I am happy to proceed with the blood test at an additional $187 No - I decline the blood tests having read the above Estimate provided by vet? Yes No If “No” I would like an estimate prior to proceeding today Yes, I would like an estimate provided This field is hidden when viewing the formSignatureAny other comments or additional things you would like done today?Do you give us permission to use photos we may take of your pet on social media? Yes No Payment at Pickup I agree to payment of the fees in full when I collect my pet from the clinic. Owners signature (or carer over 18yrs of age):Date DD slash MM slash YYYY Need help with this online form? For more information regarding orders or our services, please contact us. Call Killara: (02) 8350-5678Call Pymble: (02) 9499-4010