Hospital Admittance

Please fill out this form as completely and accurately as possible.

Get Started

Hospital Admittance Form

If you have any questions, please feel free to contact us at 775-329-4106.

Hospital Admittance & Authorization Form

  1. I certify that I am the owner of the above-named pet and am over 18 years of age.
  2. All pets entering the hospital must be free of internal and external parasites (fleas, ticks, roundworms, tapeworms, etc.) or they will be treated at owner's expense.
  3. The hospital requires that your pet be current on vaccines prior to being admitted to the hospital. If I cannot provide proof of these vaccines, I understand they may be done while my pet is here, at my expense.
  4. I have received a verbal or written estimate on today's procedure(s) for my pet(s) visit in the hospital.
  5. I understand there is a hospitalization charge for all pets staying in the hospital for 1/2 or full day.
  6. I understand if my pet undergoes general anesthesia he/she will have an IVcatheter placed and receive IV fluids during the procedure for his/her safety (with the exception of a feline neuter).
  7. Fairgrounds Animal Hospital is not a 24-hour Hospital. We do NOT have a staff member at the hospital overnight. I understand that the continuous presence of personnel is not provided during nighttime hours or weekends. I have the option of taking my pet to The Animal Emergency Center if such care is deemed necessary. I understand and agree that if I do not come for my pet by 6 pm and he/she is not stable enough to stay at the hospital unattended overnight, he/she will be admitted to the Animal Emergency Center and treated at my expense.
  8. A one-time photon laser healing therapy session is performed for post-operative incision care, treatment of inflamed tissues, and many other conditions involving pain, inflammation.
  9. I authorize the administration of oral medications , including controlled substances, to my pet if prescribed by my veterinarian. I understand these medications may be administered by a veterinary assistant.
I have read the above statements and understand these terms.

What is CPR?

Cardiopulmonary resuscitation (CPR) is a procedure to support and maintain breathing and circulation for an patient who has stopped breathing (respiratory arrest) and/or whose heart has stopped (cardiac arrest).

CPR Choices: Choose only 1 option
Pre-surgical bloodwork is strongly recommended by Dr. Parodiand may be required depending on your pet's age and/or health status.Pre-surgical bloodwork will be required depending on your pet's age and/or health status. Pre-surgical bloodwork is required for all senior pets (over 6 years old). if bloodwork is declined , I understand and accept all potential risks involved. (Additional cost for bloodwork ranges between $200 to $300) *
If bloodwork is declined, I understand and accept all potential risks involved. (Additional cost for bloodwork ranges between $200 to $300)
Safeguarding our patients is our first priority. Including an ECG in preoperative diagnostic screening is one of the most cost-effective measures we can take to ensure patient's safety during anesthetic events. This ECG is an additional $87.20.
If you pet is having a mass removed or biopsy done today:

Additional Services you would like

Would you like any of the following services done on your pet while they're sedated or under anesthesia today?
Pick up time is ONLY from 5:15pm-6:00pm. Please pick the best time for you to pick up your pet later today.

Financial Policy

How will you be paying today
Full payment is required at the time of pick up
Initials
Signature
Name
MM slash DD slash YYYY
MM slash DD slash YYYY