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Pet Portal|(864)814-0012

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Pet Portal
(864)814-0012

Services
Hours & Location
About Us
Contact

Pet Dental Form

Fill out the dentistry form below prior to your pet’s procedure.

Pet Name*

Date of Procedure*

Procedure*

I undersigned owner/agent of the pet identified above, authorize the veterinarian(s) of Ark Animal Hospital to perform the above procedures. I understand that some risks always exist with sedation, anesthesia, and/or surgery. I am encouraged to discuss any concerns I have with those risks with the attending veterinarian before the procedure(s) are performed. 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 which may be achieved. I understand that any prices which have been quoted for such procedures are for non-complicated procedures and that any unforeseen complications may result in further costs. I hereby authorize actions that may be necessary to address any complications. I have been advised that if my pet is hospitalized/boarded overnight there will be times when my pet is left unattended. I also understand that it is my option to transfer my pet to a 24-hour veterinary facility for constant veterinary supervision.*

I authorize

All dental procedures start at $180 which includes the anesthesia and cleaning/polishing only. You will receive a phone call while your pet is under anesthesia to discuss extractions. The cost of those extractions will be in addition to anything chosen on this form.*

I have read and understand

Once we establish that extractions need to be done, we will call you. If you do not answer, we will leave a message and wait for 5 minutes for you to return the call. As it is not safe to leave your pet under anesthesia unnecessarily, if you do not return the call, your pet will be recovered and taken off anesthesia and the extractions will need to be done at a later date at an additional cost.*

I have read and understand

We strongly recommend Pre-Anesthetic Bloodwork to help identify underlying metabolic/systemic abnormalities which could increase the risk of the procedure. ($67)*

Yes

No

An IV Catheter and IV Fluids help maintain blood pressure during anesthesia and give immediate access to a blood vessel if there is an emergency. This is especially important with older pets, pets who are sick or complicated procedures. ($64)*

Yes

No

Cold Laser Treatment after surgery has been shown to increase circulation, decrease inflammation and accelerate healing while minimizing pain ($54)*

Yes

No

Microchip: ($54)*

Yes

No

Dental Radiology: ($126.50)*

Yes

No

All payments are due upon discharge of the patient. A deposit may be required at the doctor’s discretion.*

I understand and agree

Ark Animal Hospital

2528 Boiling Springs Road Ste. B
Boiling Springs, SC 29316

phone: (864)814-0012
email us

Proudly serving the Boiling Springs, SC area, including (but not limited to): Inman, Spartanburg, Greer, Chesnee, Gaffney, Greenville, and Landrum.

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