Laytonsville Veterinary Practice
Laytonsville Veterinary Practice

Surgical procedure Form

 

Please review the form below carefully and submit this form at least 24 hours prior to your scheduled procedure.

the following form is not FOR SCHEDULING PURPOSES

Please call us at (301) 948-0158 to schedule your pet’s procedure before submitting this consent form.


OPTIONAL ITEMS

Our priority is to offer necessary, life-saving and life-improving surgery at prices that are affordable and accessible for all of our clients. You may notice that some of the surgical items included on this form are optional. This is to ensure that valuable procedures do not become cost-prohibitive.

All procedures involving general anesthesia do involve an inherent risk, and in an ideal situation, all of these optional items would be selected for each and every one of our patients. However, we understand that this isn’t financially reasonable for everyone, and we are proud to offer surgery that is broadly accessible to all of our patients.


Surgical procedure consent form 

Contact information
Your Name *
Your Name
Phone number where you will be reached during procedure time *
Phone number where you will be reached during procedure time
Procedure information
Procedure Date *
Procedure Date
Optional items
Some surgical costs are kept optional to keep necessary procedures from becoming cost-prohibitive. Please read carefully and determine whether you would like the following optional items.
Pre-Anesthetic Blood Work *
In order to assess the health status and identify any pre-existing abnormalities that might affect anesthesia and surgery, we highly recommend pre-surgical blood work. The blood panel is run based on the pet’s age and health status and chosen at the doctor’s discretion. Depending on the procedure, pre-operative blood work may be recommended or required. Cost: $60 - $95
IV Catheter *
The placement of an intravenous catheter pre-operatively allows our surgical team to better manage your pet’s blood pressure and cardiac output during anesthesia which makes for a safer anesthetic experience. Depending on the procedure, IV catheter placement may be recommended or required. Cost: $88
Laser Surgery *
Laser-assisted surgery is available for your pet at an additional cost. Depending on the procedure, laser may be recommended or required. Some of the advantages of laser surgery (as opposed to conventional scalpel surgery) are: - Reduce post-operative pain due to sealed nerve endings - Produces little or no bleeding sometimes present in conventional surgery - Minimizes swelling - Allows for precision in removal of abnormal tissues Cost: $88 - $115
Pain Management *
Pain management should be considered for all surgeries. The dosages and duration of medications, which may affect fees charged, will be left at the doctor’s discretion. Pain management incurs additional costs and includes both intra-operative treatments and at-home medications.
Biopsy *
For surgeries involving mass removal: Would you like us to submit the mass for histopathology? Cost: $176 - $293 depending on sites sampled
Microchip *
A microchip is useful as a means of identifying your pet if they are lost or stolen. Cost: $57
Surgical + Anesthesia Consent
Surgical Consent Agreement *
By checking the box below, you consent to anesthesia and surgical procedure for your pet, and understand that veterinary care during nighttime hours and/or weekends is provided at the discretion of the attending veterinarian. Continuous 24 hour presence of personnel may not be provided during these hours.