Dental Drop Off Form

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Owner Name
Species
Sex
(Select one)

Agreement

When any dental procedure is being performed, it is important to know the degree of periodontal disease. This is often best assessed when the pet is under anesthesia. At this time, diseased teeth are often found which could require extractions. Please initial the line below to authorize the extraction of any diseased tooth.
Do whatever is needed to give my pet a healthy mouth.
Call me for approval of any procedure or extraction not previously discussed with me or included in my dental estimate. If I cannot be reached, I understand that my pet will be awakened and a second anesthesia and dental may need to be scheduled.
Do not do any procedures beyond what has already been estimated and approved by me. I understand that my pet will be awakened from anesthesia.
Our greatest concern is the well-being of your pet. The doctor will perform a physical examination before administering anesthetic agents. Anesthesia does carry some risk, even for routine surgery. Circle B Veterinary Hospital’s doctors and staff utilize a safe anesthetic protocol unique to each patient. All patients will receive pre-anesthetic bloodwork, including coagulation times, an IV catheter, IV fluids, and postoperative pain medication if indicated.
Any known allergies or reactions to vaccines or medications?
Do you want a microchip ($50)? Nail trim under anesthesia ($6)?
Preferred pick up time:
Are there any other concerns or questions you may have?
If there are any complications (if your pet is severely ill or has a life-threatening reaction) please select one if we CANNOT reach you for decision.
Payment Method
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At Circle B Veterinary Hospital, we are dedicated to providing exceptional veterinary care with compassion and expertise. From routine wellness exams to advanced diagnostic procedures, our team is committed to keeping your pets happy and healthy. Contact us today to learn more about our services or to schedule an appointment. Your pet's health is our priority!

Hours

Monday
7AM - 6PM
Tuesday
7AM - 6PM
Wednesday
7AM - 6PM
Thursday
7AM - 6PM
Friday
7AM - 6PM
Saturday
8AM - Noon