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Feline Spay/Neuter Form
Please fill out Low Cost Form and return before your appointment. Thank you!
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Client First and Last Name
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Your answer
Current Address and Phone number.
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Your answer
Pet Name
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Your answer
Pet color and/or markings?
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Your answer
Is this a feral cat?
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Yes
No
My cat is coming in today for...
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Spay(female)-$156.60 plus an Exam if not current + extra charge if pregnant
Neuter(male)-$91.50 plus an Exam if not current
Other:
I understand that if fleas are seen on my cat, they will be treated with Revolution Plus topical at my expense($24.88).
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By checking this box, I indicate that understand the statement above
Required
I, the undersigned owner or agent of the pet identified above, certify that I am eighteen years of age or over and authorize the staff/veterinarians of Companion Animal Hospital of Waller to perform the above procedure(s) and understand that I am responsible for all charges related to this patient.
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I am 18 years of age or older
Required
In the case that your pet were to suffer cardiac and/or pulmonary arrest (heart or breathing stops), do you authorize us to provide life-saving measures (i.e. cardiopulmonary resuscitation)? Costs of these services can be between $200-$500. If you choose to allow these procedures for your pet, we will try and contact you as soon as possible to inform you of the situation and discuss the options of how to proceed.
I give my permission
I do not give my permission
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I understand that if my animal is pregnant, the pregnancy will be terminated. I also understand that pregnancy significantly increases post-operative complications including death. If my pet is in heat or pregnant, an additional charge of $38.50 will be incurred.
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By checking this box, I indicate that understand the statement above
Required
I also assume full responsibility for any additional expenses incurred after the surgical procedure is performed, such as follow up radiographs, re-check physical exams and additional surgery due to post-op complications. These are more likely to occur when there is a failure to comply with the aftercare instructions.
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By checking this box, I indicate that understand the statement above
Required
While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand that no guarantee or warranty has been made regarding the results that may be achieved.
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By checking this box, I indicate that I understand the statement above
Required
A pre-anesthetic blood profile is recommended. The pre-anesthetic blood profile checks kidney values, liver values, glucose, and blood counts. Would you like to have this blood profile performed for an additional charge of $108?
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Yes
No
Required
Would you like your pet tested for FIV( Feline Immunodeficiency Virus), Feline Leukemia, and Heartworms for an additional charge of $52.50?
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Yes
No
Required
CAHW Strongly recommends the use of E-Collars. These are used to prevent your cat from licking or traumatizing the surgical site. Price is dependent upon size ($15-$20). Would you like your pet to go home with an E-Collar today?
Yes
No
Clear selection
Female cats are given a 24 hour pain injection. Typically males are not given pain medication. CAHW recommends your pet go home with pain medication. Would you like to add an additional 3 days of oral pain medication for your cat for an additional $25.50?
Yes
No
Clear selection
Companion Animal Hospital of Waller recommends that all patients be microchipped for identification to aid in the recovery of a lost pet. Would you like to have your pet microchipped for an additional charge of $49.75?
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Yes
No
Required
During the spay/neuter, the tip of the left ear of the cat is taken off. It is an indicator that said cat is neutered or spayed. This is highly recommended for outdoor cats. Would you like your cats left ear notched?
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Yes
No
Required
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