What To Expect
Meet Our Family
Cat Friendly Practice
Preventative Care Plans
Surgical Release Form
I hereby authorize Erlanger Veterinary Hospital and its designated associates, technicians or assistants to treat, anesthetize, prescribe medications for, and perform specified diagnostic tests or surgery on my pet,
I understand the risks associated with these procedure(s)
and know that all reasonable precautions will be taken against injury, escape, or destruction of my animal and will not hold Erlanger Veterinary Hospital responsible in event of such.
If emergency treatment is required and I cannot be reached, I authorize Erlanger Veterinary Hospital to perform such procedures as are necessary to preserve the life of the patient until I can be contacted.
Please list any medications your pet has received in the past 24 hours and the times they were given.
It is the policy of our hospital to require a minimum deposit of 50% of the estimate. Please leave this payment with the receptionist when admitting your pet into the hospital.
Microchip Implant & Registration ($90.70 + tax)
Refill Heartworm, Flea & Tick Prevention (select below)
Please select which type of heartworm, flea & tick prevention
Proheart 6 Injection
Proheart 12 Injection
Flea/Tick ONLY: Bravecto
Flea/Tick ONLY: Simparica
FELINE ONLY: Revolution Plus
FELINE ONLY: Bravecto Plus
Our hospital is a
"Flea Free Zone"
will be checked for fleas upon admission. If we find live fleas on your pet,
we will treat
at a cost of $12.40.
I am the owner or authorized agent of the owner of the pet presented for care. I accept financial responsibility for treatment of the above-named patient and understand that payment in full is due upon release of my pet from the hospital or when service is otherwise terminated. I certify that I have read, fully understand, and agree to this authorization.
I have read, understand, and agree
Signature of Owner or Authorized Agent
How would you like to be notified when surgery has been completed?
***MUST BE ACCESSIBLE BY PHONE OR E-MAIL FROM 9:00 – 4:00 TODAY!!!***
Phone number where you can be reached TODAY
Alternate phone number
Cell Phone # (for Text Alert Only)
E-mail Address (for E-Mail alert Only)