Canine Spay/Neuter Form


Canine Spay/Neuter Form

Please complete the proper surgical consent form before your visit. We will get in touch with you if we have any questions.

I, the undersigned, do hereby certify that I am the owner (or a duly authorized agent for the owner) of the pet named above. I consent and authorize Robertson County Animal Clinic (RCAC) to hospitalize, administer vaccines, medications, and anesthetics; and perform tests and surgical procedures that the doctors deem necessary for the health, safety, and well-being of the patient while at RCAC.


The nature of the treatments and procedures has been explained to my satisfaction. I realize that no guarantee can ethically or professionally be made regarding the results, cure, or outcome.


I understand that I, the undersigned, assume financial responsibility for all services rendered and that payment in full is due at the time services are performed.


Should I not pay in full and my account becomes delinquent, I also understand that I am responsible for any collection fees incurred.

Clear Signature
Medical History

The following services are not included in the base surgery prices. Please let us know if you would like an estimate before your pet's procedure.

Pre-Anesthetic Bloodwork
Intravenous Catheter and Fluids
Pain & Anxiety Medications
***For the comfort of your pet, the doctor will give your pet a pain injection prior to surgery and send pain medication home. This is included in the cost of your surgery.***
Laser Therapy (Photobiomodulation) – Not Used on Growth Removals
Elizabethan Collar
Growth & Tumor Removals
Spay/Neuter Tattoo