All Creatures Veterinary Hospital Dental Authorization

You may submit this form online or click here to print out form and return to our office.
For your convenience, please allow 2 business days for processing online submissions.

Date
Owner's Name
Pet's Name

Does your pet have any problems that we need to be made aware of prior to surgery?


Preanesthetic testing consent Our caring staff members want to ensure your pet's well-being. A veterinarian will perform a comprehensive physical exam before sedating your pet. However, many disorders of the kidneys, liver, and blood can't be detected without blood tests. That's why we strongly recommend performing a pre-surgical screening before sedating your pet. Please check the options below:


Authorize the recommended pre-surgical blood screen for $95.00. I understand and assume all responsibility for additional risks or complications resulting from my refusal to approve this blood screen for my pet's safety.

Consent to perform extractions and necessary procedures
During the procedure, each tooth must be carefully evaluated so the veterinarian can choose the best treatment. To help you avoid surprise charges, a staff member will call you to update this estimate during the procedure if additional services are needed. We recommend completing all needed dental procedures during this visit so you can avoid scheduling another appointment with additional sedation costs. Please check the options below:






Pain Medicine
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.








Dental X-ray
80% of dogs and 70% of cats over 3 years old have dental disease.. Often disease lies deep below the gum line and may not be obvious on physical exam. Because teeth may look healthy and have hidden disease such as infection and decay, we recommend dental x-rays to look for these problems. Please check the options below:



Healthy Mouth Water Additive
HEALTHY MOUTH is the only VOHC approved water additive that has been shown to reduce plaque and tartar build-up on the teeth and gums when used in the pet's daily drinking water. It is safe to use long-term in both dogs and cats with no side effects.



Other Procedures














(If yes, please explain)

Would you be interested in receiving updates on your pets via text or email?

If yes, below, please list email address or cell phone number you would like us to use.

Emergency phone number:

Name
Date