If you have multiple pets, please fill out multiple forms

  • NameSexBirthdayBreedColorWeight
  • FOR ALL ANIMALS: I hereby request Animal Spay & Neuter to surgically sterilize my animal. I have had the opportunity to ask questions regarding the surgery and the risks involved. I understand that there is a risk in any surgery, that no pre-op blood work is offered and that the surgery is performed with a general anesthetic. Not withstanding the risk, I request the surgery. I hereby declare under penalty of perjury that I am the owner, or authorized by the owner, to present for operation the above animal.
  • Heartworm disease is spread by mosquitoes and is very common in this area. IT CAN CAUSE SERIOUS ANESTHESIA / SURGICAL COMPLICATIONS. Animal Spay & Neuter RECOMMENDS a heartworm test if your dog is not on heartworm preventative medication and is over 8 months of age.
  • Signed:
  • It is OK to treat my animal for: Earmites, Foxtail removal, Ear flush, Abscess, Cryptorchid if needed (fees vary)

    I understand that I must pay for the actual surgery cost at time of the appointment. The payment is NON refundable if I do not show up or cancel at the last minute. I also understand that there may be additional charges for other services.

  • This field is for validation purposes and should be left unchanged.