• I assume full financial responsibility for the above described animal and I do hereby authorize Crossroads Veterinary Hospital to hospitalize and treat this animal as the doctors deem necessary for the health, safety or well-being of the above animal while it is under their care and supervision.
  • PLEASE NOTE: There may be additional charges associated with your pet's surgery

  • 1. If your pet has an undescended testicle (cryptorchidism), there will be an extra fee of $25 if the testicle is extrabdominal or $75 if intraabdominal

    2. If your pet is not current on "Core" vaccines, they will be provided at additional ($26)

    3. If fleas found on patient, flea treatment will be provided ($8)

    4. If your dog has an unknown heartworm status, he will be tested before anesthesia ($29)

    • Current if tested negative in the previous 4 months
    • Current if tested in past year and proof of heartworm prevention can be provided
  • Optional Recommendations

  • Pre-op Bloodwork: We offer and strongly recommend pre-anesthetic bloodwork for all pets undergoing surgery.
  • Although not imperative for all procedures, we do recommend for any procedures involving incisions and dental treatments involving extractions.
  • Microchipping

  • A microchip placed under the skin between the shoulders can help increase your chance at recovering a lost or stolen pet. It is safe and effective, and if done during anesthesia, unnoticed by the animal. We highly recommend microchipping during your surgery. Includes lifetime registration.
  • Social Media (Facebook)

  • Crossroads has a Facebook page and loves to brag about our special patients. Along with the picture we would put the patients' name, but never the clients' name or information. If we have permission to put your pets' picture on Facebook.
  • If anything detrimental should accidentally occur to this animal while in the hospital, I will hold Crossroads Veterinary Hospital free of any responsibility and/or liability in the absence of gross negligence. I understand that payment in full is due at the time the animal is discharged. If I neglect to pick up the animal within five (5) days of written notice that it is ready for release and mailed to the above address, you may assume that the pet is abandoned. You are then authorized to dispose of it as you see fit. Abandonment does not release me of my obligation for the bill. I further agree that in the case of non-payment, a finance charge of 1.5% per month (18% per annum) will be charged and that any collection fees or attorney fees will be paid by me.
  • PLEASE LEAVE A RELIABLE PHONE NUMBER WHERE YOU ARE AVAILABLE DURING THE PET'S PROCEDURE
  • Contact Preference