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The Small Animal Clinic at Colorado Equine

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Office Visit and Patient Drop-Off Release Form

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  • The Small Animal Clinic at CEC

    Thank you for trusting us with your pet today! The following information will be used by our veterinary team to understand your desires for your pet's visit today.

  • MM slash DD slash YYYY
  • We will need to be able to contact you or someone with permission to make medical and financial decisions:
  • During surgical procedures, please be available throughout the day for calls.
  • :
  • (Pick-up times will vary depending on procedure and caseload; We will call when your pet is ready for pick up)
  • Additional Services for Your Pet's Care & Safety

  • Microchip: Many pets will become lost at some point in their lifetime. Some are never found but with a microchip, your pet can be identified even if no collar or tag is present. A microchip increases the chances of being reunited with your pet if lost. Doctor discretion with small or young pets. ($56)

    Nail Trim: Long nails can cause discomfort for the pet and can cause damage to the delicate structures of the feet. Would you like your pet's nails to be trimmed today? Pets who are undergoing an anesthetic procedure will have their nails trimmed at no charge. ($32)

    Anal Gland Expression: If you have noticed any licking/scooting or chewing, their glands might be blocked and require a manual expression. ($23)

    Pre-medicate prior to Vaccinations: While the chances of vaccine reactions are low, there is always a risk for your pet to react even if they have had no prior history or symptoms of vaccine reaction (soreness, swelling, vomiting, diarrhea). We may recommend a diphenhydramine injection prior to vaccination to minimize the chance of a reaction. Post-vaccination pain medications are also available. (varies)

    Heartworm Prevention: Does your pet need a refill on heartworm prevention? We recommend year-round prevention. Heartworm disease is caused by a long slender worm that lives in the heart and adjoining vessels of infected pets. Heartworms are transmitted by mosquitoes and can cause substantial damage to the heart and lung before the pet shows any sign of disease and can also be fatal. Dogs will require a yearly heartworm test preformed prior to prevention being administered. (varies)

    Flea & Tick Prevention: Does your pet need a refill on flea and/or tick prevention? Fleas and ticks can carry and cause disease and discomfort in humans and animals. Ask about available products for recommendations. (varies)

  • If your pet is undergoing sedation or anesthesia today, please read and initial

  • Initial
  • Initial
  • Initial
  • Authorization

  • I authorize, the doctors and staff of "The Small Animal Clinic at Colorado Equine Clinic" complete authority to perform procedures including anesthesia, surgery, diagnosis, dentistry (including extractions), any additional diagnostic procedure, or treatment to promote the patient's wellbeing, and or help with their medical conditions. I understand that the Doctors and staff will use all expected precautions against injury, escape and death of my pet. I also understand that all sedation/anesthesia involves an innate risk and in rare occurrences death. I release the Doctors, staff, and "The Small Animal Clinic" from any and all liability arising from all treatments, anesthesia, and procedures involving my pet.
  • MM slash DD slash YYYY
  • By signing, I am consenting as either the owner or legal agent of the owner.
  • This field is for validation purposes and should be left unchanged.

Phone: (303) 791-0195

Address: 9616 W Titan Rd
Littleton, CO 80125

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Monday – Friday: 8:00am – 5:00pm

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