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Dental Surgical and Medical Consent Form

FF/SMM/N

FelineCanine

Please answer the following questions:

yesno

yesno

yesno

yesno

yesno

yesno

yesno

yesno

**If yes, please bring a small meal for your pet. Please note that raw diets are prohibited**

Mendon Village Animal Hospital recommends flea/tick & heartworm preventatives to be given year-round. Lyme disease is extremely prevalent in our area.

Please answer the following regarding your pet’s current flea/tick & heartworm preventative routine.

yesno

yesno


phonetext

In the event that I cannot be reached for a surgical update, I agree to pay for additional services and/or extractions that the doctor deems medically necessary.