Surgery/ Anesthesia Authorization

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updates on my pet's surgery status
Pre-Surgical Questionare
If yes, please present your pet's vaccine certificate (if from another veterinary clinic)

To protect your pet and the other pets entrusted to our care, all animals admitted to the hospital must be current on vaccinations, administered by a veterinarian, in an effort to prevent them from contracting or passing along any illness while in our care. Proof of vaccination is required at the time of admission; if you do not have proof of vaccination we would be happy to contact the veterinarian who vaccinated your pet for you. If vaccines are not current or proof is not available, then we will vaccinate your pet while here.

Recommended services offered by Locust Trace Veterinary Clinic

The doctors and anesthesia nurses at Locust Trace Veterinary Clinic routinely utilize EKG, pulse oximeters, respiratory, and temperature monitors during all anesthetic procedures. In addition there are other recommendations that are offered under general anesthesia.

***Please note that any animal undergoing a surgical procedure will be administered post operative pain medication, and may be sent home with an oral regimen. This is a MANDATORY service to ensure quality patient comfort and care at an additional cost ranging from approximately $20 - $55***


In the event that the doctors deem a tooth/ teeth are in need of extraction, I hereby authorize the extraction of the tooth/teeth at additional cost. (estimated $18-$40 per tooth)


I understand that with every surgery there are inherent risks, including reactions to anesthesia. In the rare instances that my pet may have a medical crisis while under anesthesia,

I hereby authorize the staff of Locust Trace Veterinary Clinic to perform the above procedures for my pet. The nature of the procedure(s) has been explained to me, and I understand and assume responsibility for all risks included in the surgery(s)/treatment for my animal. At the time of discharge, I agree to pay in full for services rendered, including those deemed necessary for medical or surgical complications or unforeseen circumstances.

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A Veterinarian for Your Exotic Pet

If you are looking for a veterinarian for your exotic pet, you will find Dr. Rachel Cullman-Clark will help you take care of just about any pet you have. This is great news for those of us who love animals and enjoy the company of unconventional pets.  Special animals require special care and it’s nice to know when you have a concern about your pet you have somewhere to turn to.

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Application For Spay/Neuter Discount

This discount is offered through the cooperation of the Humane Society, A.L.L., Madison County area veterinarians, the Madison County Fiscal Court, the City of Richmond, and the City of Berea. Authorization of this certificate is dependent on the availability of funds.

(check appropriate box to the right)

I certify that this info is correct & that I need financial assistance:

Due to limited funds, there is a limit of 2 certificates per family per year. This certificate is only good for the animal indicated above and must be used prior to the expiration date. Authorizations are good for 60 days only. If the certificate expires before you use it. you will need to reapply. Present this authorized certificate to your veterinarian at the time you leave your pet for surgery.

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New Client Form

Please fill in the form below.

Full Name
Phone Number
Pet Information

Client Agreement: I understand that AAC utilizes the services provided by the Madison County Attorney for returned checks and all accounts sent to the county attorney are subject to additional fees and penalties. I also understand any balance that remains unpaid for any reason will be sent to a professional collection agency and I agree that I will be responsible for additional fees and penalties incurred to Advanced Animal Care for collections on this account, as well as interest accrued at 1.5% monthly (18% annum). Advanced Animal Care reserves the right to present past due accounts to small claims court in place of a collection service. I have read the above and understand the hospital payment policy. I acknowledge that I am the responsible owner of the pet(s), or authorized agent of the owner, associated with the below named pet(s) and represent all other owners. I assume responsibility for all charges incurred in the care of the animal. You must be 18 years or older to legally sign this consent. All fees are due at the time services are rendered. AAC does not offer payment plans, but clients may apply for Care Credit.

Click below to consent to treatment of your pet and to authorize us to release your pet's records if necessary *

I, being responsible for the required animal, have the authority to grant my consent to receive, prescribe, and treat my pet. Further, I accept full financial responsibility for authorized medical treatments. I also authorize AAC to transmit my animal's records to other veterinarians if necessary.

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Saul Rivas

Very professional and great place. Very knowledgeable staff. Would recommend!
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