Surgical Policies and Procedures Form

Thank you for giving Chester Animal Clinic the opportunity to care for your pet(s). To ensure the best care possible, please fill out this form completely. We’ll reach out with any questions.

If you or anyone in your household (including your pet) has been exposed to COVID-19 or tested positive for COVID-19 in the last two weeks, we ask that you schedule your appointment ten days after you are symptom- and fever-free. Thank you for your consideration.

Surgical Policies and Procedures

Your pet’s doctor has recommended for your pet to have a surgical procedure. We have found the best way for our clients to understand our surgical procedures and protocol is to provide them with our Surgical Policies and Procedures Information before their pet’s surgery so that there are no misunderstandings or miscommunications between you, the Doctor and our staff. We ask that before scheduling your pet’s procedure you read this information in its entirety so you can make an informed decision. *

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Pre-Surgical Requirements/ Vaccines and Medical Services

All procedures require a 20% deposit at the time you schedule your pet's procedure. The deposit will be applied to the balance due at discharge. The deposit will be refundable if you give us at least 48-hour notice of the cancellation. For more complex surgeries (orthopedics and ear cropping) we require a 72-hour notice. Leaving a voicemail after hours on the weekend for a Monday or Tuesday procedure will not suffice as an appropriate notice. If you do not cancel within that time and/or do not show up for your pet's scheduled procedure the deposit will be forfeited. *

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All pets MUST be up-to-date on all vaccines and medical services. • For canine patients we require a current: Rabies, DHPP-C, every six months an Infectious Tracheobronchitis Vaccine, Fecal Analysis (within the past 6 months) and, if over 6 months of age, a negative heartworm test within the past twelve months. • For strictly indoor feline patients we require a current: Rabies, FVRCP, Fecal Analysis (within the past 6 months) and a FELV/FIV test performed once in their lifetime. • For indoor/outdoor or outdoor feline patients we require a current: Rabies, FVRCP, FELV, Fecal Analysis (within the past 6 months), and a FELV/FIV test performed within the past twelve months. If our staff did not inform you of any overdue vaccines/medical treatments when you checked out, you can find your pet’s vaccine/medical treatment due dates printed at the bottom of each invoice. The Technician or Exam Room Coordinator who generated your treatment plan for the recommended or upcoming surgery more than likely included any vaccines and/or medical services that were overdue or would be due at the time of surgery on your treatment plan, if they didn't, they will be added to your pet’s treatment plan/invoice on the day of surgery. If your pet is not up-to-date, we can get them current on the day of your pet's procedure; this will be added to your pet's estimate/invoice. *

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Your pet must be free of internal and external parasites, such as fleas, ticks, and ear mites, as they are easily transmitted to other pets. If your pet is found with parasites they will be treated immediately at your expense. We assume when creating an estimate that your pet is parasite-free so typically this is not initially added to each estimate. *

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Wellness Exams and Pre-Anesthetic Blood work

All surgical patients are required to have a wellness exam and pre-anesthetic blood work within the past 30 days. We take these preventative measures to ensure we are performing surgery on healthy pets. We prefer to get blood work done before the day of surgery; this is more affordable for our clients and allows us to schedule our surgeries accordingly. If the diagnostic blood work comes back with abnormal results the Doctor may call you to postpone or recommend other services/treatment before the surgery can be done. If the Exam and blood work have not been done due to a lapse in treatment or this is an emergency treatment, these services can be done on the day of surgery and will be added to the estimate/invoice. If the Doctor notes any abnormal results from the exam or diagnostic blood work performed on the day of surgery, your pet’s surgery may be postponed and you will be called by the Doctor to discuss your pet’s medical issues and/or necessary treatment(s) to proceed. *

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Potential Risk

Your pet will be anesthetized during their procedure. Please understand that anytime anesthesia is used or a surgical procedure is done there are potential risks; we encourage you to discuss any concerns you have about those risks with the attending Doctor/Licensed Veterinary Technician before the procedure(s) is/are initiated. We want you to be an educated, informed client so please feel free to ask any questions during your initial visit with the Doctor, when you are scheduling your surgical procedure or at the time of your surgical check-in. If your pet should injure itself in an escape attempt, refuse food, soil itself, become ill or die while in the clinic, before, during or after surgery or after discharge, Chester Animal Clinic will be free of any responsibility and/or liability in the absence of gross negligence. Please understand that all procedures will be performed to the best of the abilities of the staff at this facility, and that veterinary medicine is not an exact science and that no guarantees have been made regarding the outcome of this/these procedures. *

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Food and Water Consumption

NO food should be consumed by our patients 12 hours prior to their surgical procedure. This is done as a preventative measure to ensure they do not choke during their surgery. Water can be offered to them up to the time of surgery. *

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Surgical Check-in

To ensure that you completely understand the potential risk, procedure and cost we ask that the person who will be financially responsible for the patient check the pet in for surgery. If that person is unable to check the pet in, we can email any information to the financially responsible party ahead of time to ensure there is no loss in communication or understanding. The treatment plan (or estimate) will need to be signed by that party and brought in before the surgery check-in. All surgical patients MUST be checked in the morning of their surgery by 7:15 AM. If you are late, your pet’s surgery will need to be re-scheduled. *

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Emergency Contact Information

We require that each client leave a phone number that they can be reached at ANY time during the day. This will be the phone number that the Doctor will use after the procedure is done to let you know that your pet is now out of surgery and comfortably recovering; to contact you in case of emergency; to discuss any additional medical treatment/procedures that may be required, or to go over homecare instructions. *

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Treatment Plan Policy

Please note that we will be giving you a treatment plan (or estimate) for your pet’s procedure. We will be as accurate as humanly possible but they are just estimates, NOT final invoice amounts. There will be additional charges applied to your invoice, if your pet is in heat, coming in or out of heat, pregnant, cryptorchid, or if surgery time is extended due to unforeseeable complications. The cost of extended surgery time is $7.00/minute. The cost of dental surgery is $8.50/minute. There may be additional circumstances beyond our control (or knowledge) that the Doctor may come across during surgery, i.e. we may need to take lifesaving actions during surgery, the Doctor discovers additional medical issues once the surgery has begun, or additional medical treatment/services need to be performed. If possible, the Doctor may call you to get authorization. If there are lifesaving actions that need to be done immediately, calling you will not be an option. Unless you specifically let us know NOT to take lifesaving actions when you check your pet in for the procedure, we will do everything possible to save your pet’s life. With these additional services comes additional expense, your invoice will reflect any additional services/treatments that were taken and/or needed. *

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Payment policy

We understand that our clients budget their finances and everyone’s income just doesn’t seem to go as far as it used to. We generate treatment plans for all wellness visits, sick/injured visits and surgical procedures so you’ll have an approximation of what the surgery will cost. With the state of the economy, we simply cannot offer payment plans at this time, we do accept Cash, Checks, MasterCard, VISA, and CareCredit. If you are utilizing CareCredit to pay for your pet's surgery we ask that you get pre-approved by visiting the CareCredit website, www.carecredit.com, before the day of surgery; this will save you time and avoid any surprises if you need to find an alternate avenue to pay for their procedure. The staff will be happy to provide you with a treatment plan in advance so you'll know what credit limit you'll need to request. We will ask you to sign the treatment plan during your pet’s Check-In as a show of good faith that you understand what the procedure cost will be, approximately, and that you are agreeing to pay for your pet’s procedure in full at the time of discharge. *

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Post-Surgical Care/Discharge Appointments

After every procedure we schedule a discharge appointment to go over with you the homecare instructions, medication to be given at home, and when your pet needs to come back for a re-check appointment. Please plan on this taking a few minutes so you will have a full understanding of how to properly care for your pet once you get them home and to allow time to ask any questions that may come up during this process. Proper at-home care is pivotal in their recovery, and is as important as the surgical procedure we just performed. If you take shortcuts, you could increase the length of time for your pet to recover, risk the incision getting infected, and/or risk your pet’s well-being. Doing so could potentially risk their health and lead to additional necessary treatments/procedures; this could result in additional costs for you. To avoid both the risk to your pet and your wallet, please closely follow all instructions given to you at your Discharge Appointment. To prevent any loss in communication or understanding please have the pet’s at-home caretaker present for the Discharge Appointment. You will also be given written instructions to take home to ensure you have something to review, should you have any basic questions about their homecare. However, please don’t hesitate to call us however should any questions come up that are not addressed with your Homecare Instructions. *

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I acknowledge that I have read, understand and agree to the above policies and that a copy has been provided to me. *

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Client's Signature *

Client's Name *

Client's Email *

Phone Number *

Pet’s Name *

Date *