Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

New Client Form

I understand that any anesthetic or surgical procedure(s) that I have authorized carries a serious risk and that unforeseen conditions may arise. I accept the veterinarian's professional judgement and I agree to indemnify the Platte Lake Veterinary Clinic, its servants or agents from any loss or liability which may incur. I also do hereby acknowledge that I understand that there are no guarantees either expressed or implied that the procedures authorized will be without complications from unexpected events beyond the veterinarian's and hospital's control. I have also had the likely fees explained to me and accept responsibility for payment of these fees at the time of the patient's discharge.

Clear Signature


TEST #1 (COST $118.45) The combination of blood tests we recommend for the healthy young pet (under the age of 5) and REQUIRE for the pet that is 5 years old or older is as follows:
-* BUN, Creatinine, ALT, ALK, Total Protein, Glucose (kidneys, liver, diabetes)
-* CBC (Anemia, Infection, Clotting) -* Electrolytes (sodium, potassium, chloride)
TEST #2 (COST $134.75) The combination of blood tests we recommend for the older pet (5 years old and older) is as follows:(This test is also recommended for pets under the age of 5)
-* BUN, Creatinine, ALK, ALT, Glucose, Total Protein, Total Bilirubin, Phosphorus, Amylase, (kidneys, liver, diabetes) -* CBC (anemia, infection, clotting)
-* Electrolytes (sodium, potassium, chloride)

You can call after 2:00 p.m. on the day of the surgery to check on your pet's status.