Spay/Neuter Consent Form - Lone Mountain Animal Hospital

Please only use this form if directed to by a member of Lone Mountain Animal Hospital’s staff as this form is used to authorize us to spay or neuter your pet.

Pet Owner's Signature (required)

Pet Information

Pet Name (required)

Pet Breed (required)

Pet Sex (required)
MaleFemale

Pet Age (required)

Pet Owner Contact Information

Name (required)

Phone Number (required)

Email Address (recommended)

Receive Text Updates on Your Pet's Condition?
YesNo

Preoperative Blood Tests

Preoperative blood testing can screen for liver and kidney diseases, anemia, and other disorders that may present, and my place my pet at an additional anesthetic risk. For patients < 5-years-old we recommend the pre-operative profile with complete blood count. For the protection of our patients > 5-years-old or pets with pre-existing medical conditions a complete chemistry profile and complete blood count is mandatory.

Select One (recommended)
YES, I want pre-surgical blood testing performed.NO, I do not want pre-surgical blood testing performed. I assume all responsibility in the refusal of this testing and my pet is under 5 years of age.

HomeAgain Microchip

The implant fee for a pre-paid, registered microchip is $45.

Select One (recommended)
Yes, I want my pet microchipped.No, I don't want my pet microchipped.