Post-Op Update
Due for:
At the time of drop off, when was the last time medications would have been given? Please list each medication (other than monthly preventatives such as heartworm, flea & tick)
If so please list below along with a timeframe.
Patient’s last meal was last night before 12am.
Did you receive an estimate for the surgery and are you approving the estimate as is? *
Would you like discharge instructions emailed or printed?
Would you like a Microchip to be implanted at the time of surgery (Spays and Neuters)
We will contact you at the listed numbers on the account and the one listed here. In the event that you are not reachable, would you prefer us to proceed with any additional recommended treatment?
Payment type (How do you intend to pay for the procedure)

Specialist Surgeries: We require a deposit of $2,000.00 with Dr. Bilicki. Once deposit is taken, you have 72 hours before the procedure to cancel and get $1,000.00 refunded. 
CPR- Your pet may require cardiopulmonary resuscitation (CPR), including cardiac compressions, positive pressure respiration, emergency medications, or other interventions. If I request such emergency procedures, I agree to be held responsible for veterinary services provided to my pet while staff members pursue treatment and try to reach me for further directions. Regardless of my pet’s recovery or survival, I agree to pay CPR fees in addition to other fees already identified by the practice and agreed upon by me. Please select one of the following:

Before submitting this Anesthesia Form, please read this Important Surgical Information.

Please initial below that you have read the surgical information.

I am confirming that I am the owner of the above named pet and that I accept full financial responsibility. I understand the nature and purpose of these procedures and the associated risks. I am authorizing Boca Park Animal Hospital, its Veterinarians and staff to complete these services for the above listed Pet.

Sign above