Animal Health Center

359 State Highway 67
Amsterdam, NY 12010


Anesthesia/Surgical Authorization

   Preoperative screening greatly reduces anesthetic risks by detecting system irregularities like anemia, kidney, and liver dysfunction.  We recommend that blood screening be performed prior to the administration of anesthesia.

Please indicate your choice(s) below:

  • Heartworm & Lyme Test (dogs only) Cost: $58.00.  If combined with other blood work below, cost is $49.00
  • Feline Leukemia Virus (Felv) & Feline Immunodeficiency Virus (FIV) Test (cats only) cost: $62.00  If done with other bloodwork below, cost is $53.00.
  • Packed cell volume:  Checks for the presence of anemia.  Cost $22.00
  • Mini Screen and CBC: These 24 tests check internal organ function such as kidney and liver values, red blood cell counts, and two blood clotting factors.  Cost $78. This test needs to be done at least two days before surgery.
  • Full CBC & Profile:  These 37 tests also check internal organ function but also checks electrolytes and thyroid function.  This test is usually done for older pets or for pets who have had a previous medical problem.  Cost $l58.00
  • I decline all pre-anesthetic blood work.

            The placement of an intravenous catheter and administration of fluids during surgery help to maintain your pet's hydration and blood pressure.  It also allows immediate access to the blood stream for administration of medication in case of an emergency.  The cost is an additional $78.00

  • Yes, I would like my pet to have intravenous fluids during this procedure
  • No, I decline, intravenous fluids.

I understand that there are risks involved with any anesthetic procedure, and that no guarantee has been or can be made as to the results of today's procedure.


Pet's name:_______________________________________________________________________  Date: __________________________________________________________________-

Owner's Signature: _____________________________________________________________________________