1601 N. Main, Pearland, Texas 77581
Phone: (281) 485-2496
Fax: (281) 485-0681
www.pearlandanimalhospital.com
Dear Client:
Your pet has been scheduled for an upcoming procedure in the near future. In our attempt to assist clients, we
have put together this packet to make sure procedure day is as easy and stress free as possible.
On the final page you will find a release form that pertains to your pet’s particular procedure. Please read the
information carefully and be sure to initial and sign each place applicable. Bring this completed form with you
on the morning of your pet’s procedure in order to speed up your pet’s check-in process. Please call us if you
have any questions or we will be happy to answer your questions during drop off.
We will require a phone number that you can be reached at on procedure day. Failure to be reached on
procedure day may result in postponement of the procedure.
The night before your pet’s procedure….
 Withhold all food and treats after 10pm.
 Water may be left down after this time period.
 If you are currently administering any medications, vitamins or injections withhold the morning dose
unless instructed otherwise by your veterinarian.
Please make arrangements for your pet to be dropped off between 7-8am on the procedure day, unless other
arrangements have been made in advance. At the time of drop off, our team will be happy to answer any
questions or concerns and collect all necessary paperwork.
Our veterinary technician will escort your pet to the prepping area and wait to their procedure. If you have
elected any of the additional testing on the following page such as blood work, the veterinary technician will
collect these samples and tests prior to the procedure.
If any questions arise, the veterinarian may contact you at the number you provide on the authorization form.
You are welcome to check up on your pet’s status, however, we request that you allow plenty of time for your
pet’s procedure to be done. At this time, we will be able to give you an idea when your pet may be discharged.
When you arrive to take your pet home, the receptionist will bill you out and the veterinary technician will go
over all discharge instructions. If you do not understand any instructions, please do not hesitate to ask them to
go over them one more time.
We hope your pet’s procedure day will be a pleasant experience. Remember, our team knows procedures can
be an anxious time and we are always available to answer any and all questions concerning the upcoming
procedure.
We look forward to serving you and your pet on the upcoming procedure day and years to come.
Thank you for choosing Pearland Animal Hospital.
Please call (281) 485-2496 if you have any questions or concerns.
Dr. Stevener • Dr. Schoeffler• Dr. Vance • Dr. Parbhoo• Dr. Henry
1601 N. Main, Pearland, Texas 77581
Phone: (281) 485-2496
Fax: (281) 485-0681
www.pearlandanimalhospital.com
Below you will find explanation of optional testing that we provide for your
pet’s procedure. Please accept of decline these options on the final page.
Basic Blood Panel: Chem 10 with CBC + Electrolytes (Pets less than 5 years of age) – This
test shows us your pets basic chemistry profiles that which in turn enables us to view the current
functions of the heat, liver, kidneys, blood counts, etc. This test is important to aid in the
assurance your pet is healthy to sustain anesthesia for his or her procedure.
Full Blood Panel: Chem 17 with CBC + Electrolytes (Pets older than 5 years of age) - This
test shows us the same results as the above Chem 10 however it gives us much needed additional
information on senior pets such as additional electrolytes, liver enzyme testing and pancreatitis
testing. Again this test is important to ensure your pet is healthy to sustain anesthesia.
Heartworm Testing - Annual testing is necessary, even when pets are on heartworm prevention
year-round, to ensure that the prevention program is working. Heartworm medications are highly
effective, but pets can still become infected. If you miss just one dose of a monthly medication—
or give it late—it can leave your pet unprotected. Even if you give the medication as
recommended, your pet may spit out or vomit a heartworm pill—or rub off a topical medication.
Heartworm preventives are highly effective, but not 100 percent effective. If you don’t get your
pet tested, you won’t know if your pet needs treatment.
FeLV/FIV Test - Feline leukemia virus (FeLV) and feline immunodeficiency virus (FIV) are
contagious, untreatable diseases in cats. Cats that go outside are at increased risk for exposure to
FeLV and FIV. Testing for FeLV and FIV is often performed at the same time since clinical
signs can be similar. FeLV is generally transmitted through contact with saliva from an infected
cat. Certain social behaviors such as mutual grooming and sharing food or water bowls can
spread the disease. Kittens can become infected during fetal development or during the first days
of life as their mothers nurse and care for them. Like FeLV, FIV is also transmitted through
contact with saliva from an infected cat. However, most cats contract FIV through bite wounds
sustained during fights with FIV-infected cats rather than through social behaviors. Because of
territorial behavior and related aggression of cats (particularly male cats) roaming outside tends
to increase the risk for exposure to FIV.
Dental X-Rays - Dental radiographs are one of the most important diagnostic tools available to a
veterinary dentist. They allow the internal anatomy of the teeth, the roots and the bone that
surrounds the roots to be examined which cannot be done with the naked eye. Because
veterinary patients will not cooperate when a radiograph or sensor is placed in the mouth, taking
dental radiographs requires that the patient is anesthetized or sedated which is why we need to do
this during the dental procedure. It is common for a patient being treated for one specific
problem to have additional oral problems which only become apparent when the dental
radiographs are made. If there are no other findings, the dental radiographs are a great base-line
Thank you for choosing Pearland Animal Hospital.
Please call (281) 485-2496 if you have any questions or concerns.
Dr. Stevener • Dr. Schoeffler• Dr. Vance • Dr. Parbhoo• Dr. Henry
1601 N. Main, Pearland, Texas 77581
Phone: (281) 485-2496
Fax: (281) 485-0681
www.pearlandanimalhospital.com
for future comparison. The radiation risk to the patient from taking dental radiographs is
minimal.
Microchip - It is never too late to get a microchip for a pet. Dog and cat microchipping is a
simple procedure. A veterinarian simply injects a microchip for pets, about the size of a grain of
rice (12mm), beneath the surface of your pet’s skin between the shoulder blades. The process is
similar to a routine shot, takes only a few seconds, and your pet will not react any more than he
would to a vaccination. No anesthetic is required. It is a permanent pet ID. The microchip itself
has no internal energy source, so it will last the life of your pet. It is read by passing a microchip
scanner over the pet’s shoulder blades. The scanner emits a low radio frequency that provides the
power necessary to transmit the microchips unique cat or dog ID code and positively identify the
pet. If your pet gets lost and is taken to an animal shelter or veterinarian, they will scan the
microchip to read its unique dog or cat ID code. This is the number used to identify the pet and
retrieve your contact information, which is used to contact you and reunite you with your pet.
Thank you for choosing Pearland Animal Hospital.
Please call (281) 485-2496 if you have any questions or concerns.
Dr. Stevener • Dr. Schoeffler• Dr. Vance • Dr. Parbhoo• Dr. Henry
1601 N. Main, Pearland, Texas 77581
Phone: (281) 485-2496
Fax: (281) 485-0681
www.pearlandanimalhospital.com
SURGERY RELEASE FORM
Date:
Client
Patient:
Primary number for today: (____) ________________
Secondary number for today: (____) ______________
Procedure: ________________________________________________________________
Vaccinations: I understand that if my pet is not current on his/her vaccinations but is healthy enough to receive them, the vaccinations
will be administered and the appropriate fees will be added to my invoice. (This is a mandatory hospital policy.)
Parasites: If my pet has not had a fecal examination within the past 6 months, my pet will be tested and any necessary medications
will be recommended. If fleas and/or ticks are found on the initial examination, I understand my pet will be treated with the necessary
fees added to my invoice. (This is a mandatory hospital policy.)
Some conditions are not evident on physical examination and in any procedure requiring anesthesia is associated with a certain
amount of inherent risk regardless of the patient’s age and/or medical history. We want to minimize this risk as much as possible and
we can better evaluate your pet’s overall health and ensure his/her safety by performing a pre-anesthetic blood panel. This blood work
enables us to evaluate and detect subtle changes in your pet’s blood chemistries that we would not otherwise be able to detect such as
early kidney and liver disease.
Please indication your selections below:
1.) Basic Blood Panel: Chem 10 with CBC + Electrolytes
This panel is for healthy pets less than 5 years of age.
$98.00
(
) Accept
(
)Decline
2.) Full Blood Panel: Chem 17 with CBC + Electrolytes
This panel is for sick and/or pets older than 5 years of age.
$171.90
(
) Accept
(
)Decline
3.) Heartworm Test:
$59.90
(
) Accept
(
)Decline
If your pet has not been tested, we strongly encourage this test to ensure heartworms are not present. Heartworm Disease
increases anesthesia risk.
4.) CATS ONLY: FeLV/FIV Test:
$98.40
(
) Accept
(
)Decline
If your pet has not been tested, we strongly encourage this test to ensure your pet is FeLV/FIV negative. This diseases increase
anesthesia risk
4.) Microchip: administered for permanent identification
$50.00
(
) Accept
(
)Decline
5.) Dental disease can cause heart, live and kidney infections. Ask your veterinarian if it is time for a dental cleaning on your
pet’s teeth.
INITIAL HERE, if you would like a dental cleaning added to your pet’s surgical procedure today for an additional $87.90.
(
) Accept
(
)Decline
Dental X-Rays:
$99.50
(
) Accept
(
)Decline
These will help to identify diseased roots and abscesses that cannot be seen on physical examination.
Extractions: The extent of dental disease cannot be completely assessed until the patient is sedated and a thorough dental examination
is performed. If a diseased tooth is found, the veterinarian will evaluate it and determine if an extraction is medically necessary. The
appropriate fee will be added to your invoice.
I have read and understand the above consent form and authorize Pearland Animal Hospital to perform this procedure(s)
and/or operation(s) on my pet. I assume full financial responsibility for all charges related.
___________________________
Owner Signature
___________
Date
Thank you for choosing Pearland Animal Hospital.
Please call (281) 485-2496 if you have any questions or concerns.
Dr. Stevener • Dr. Schoeffler• Dr. Vance • Dr. Parbhoo• Dr. Henry