Surgical Consent Form in Tulsa, Oklahoma - Woodland West Animal Hospital

Name*

First Last

Phone*

Would you like surgical updates via text?:*

Yes
No

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Pet's Name*

I authorize the doctors and staff of Woodland West Animal Hospital to perform the following surgical, dental, or diagnostic procedures on my pet:*

Procedure being performed

CO2 Laser Surgery*

Yes, I want my pet to have laser surgery and I understand that this cost is in addition to normal surgery costs. (Spay/Neuter: $53.50, Skin Masses: $133.75
No, I decline laser surgery for my pet.

I also want my pet to have the following additional services:

Microchipping*

Yes, I want my pet to be microchipped today. (44.93)
No, my pet is already microchipped.
No, I do not want my pet to be microchipped.

Additional Services:

Total Care (includes all recommended vaccines, heartworm & fecal parasite test - $162.64)
Heartworm Test ($39.00)
Heartworm prevention refill
Tick/Flea prevention refill

Client Signature (Please Type Your Name to Sign). By clicking submit I acknowledge that my pet's procedure and its possible complications have been fully explained to me. I understand the risks associated with general anesthesia and that this may include death.*