• Please read carefully and fill out the form completely.


  • I hereby authorize the following surgical procedure to be performed by Doctor Connelly:
    The nature of such service has been described to me to my satisfaction and I realize that no guarantee or warranty can ethically or professionally be made regarding the results or cure. I also understand that I assume financial responsibility for all services rendered, and that payment is due upon dismissal of my pet.
  • Date Format: MM slash DD slash YYYY
  • Before putting your pet under anesthesia, we will perform a full physical exam. However, many conditions such as liver, kidney, or blood disorders cannot be detected unless a blood test is performed. This testing is mandatory for all pets prior to any surgical procedures. For pets under 1 year of age the cost is $51.00. More comprehensive testing is required for pets over 1 year of age, and the cost is $74.00. Our lab is fully equipped to give results immediately, before any anesthesia or surgery is performed.

  • *Any pets found to have fleas will be treated at owner’s expense.