Pet Information Pet Name:   (Female) Spay (Male Neuter) Dog Cat Breed:    Age: Color:   Weight: lbs.  Owner Information Owner's Name: Address:   City: Zip: Home Phone: Work Phone: Email: Yes, I want to microchip my pet. ($10 additional) No, I do NOT want to microchip my pet. Please check each line that you have read and understand surgery requirements. My pet is at least six months of age. My pet is not on any type of medication other than heartworm and flea preventative. For my pet’s safety, if five years of age or older, the animal must have been seen within the last six months by a veterinarian. Records of physical examination and blood chemistry must be faxed or presented to the League prior to surgery. I understand that I should not bathe my pet within three days before the surgery date. My pet is not in heat and is not nursing puppies or kittens. My pet does not have any sores or injuries. I understand that the League will not perform surgery on my pet if it is found to be ill. I will not give my pet anything to drink or eat after midnight the night before surgery. I will drop-off my pet between 7:30 a.m. and 8:00 a.m. on the scheduled surgery date. I will pick-up my pet between 7:30 a.m. and 9:00 a.m. the following day. I understand that my pet must be returned in seven days for suture removal. No professional services other than the spay/neuter surgery and microchip identification implant will be performed by this Clinic. The League will exercise ordinary care and prudence in the selection of animals suitable for surgery and in the performance thereof. It will not be responsible for any condition in the animal not directly connected with the operation. I certify that I am the sole owner of the above-described animal. I understand that this surgery will be performed by a Veterinarian for a fee of $25.00 or $100.00. The $25.00 (Cat) or $100.00 (Dog) fee is required in advance to schedule an appointment and is non-refundable. I hereby release Peggy Adams Animal Rescue League and the performing surgeons from any liability, which may arise from the surgery or a complication thereof. I have read and understand the above application and I agree to its terms. Owner Signature: If you have not received a phone call from us to schedule your appointment within five days of submitting this application, please call us at (561) 686-3663, ext. 167.

For your pet’s protection please read carefully:

1. Age - All pets booked for surgery must be at least six (6) months old.
2. Medications - Pets cannot be on any type of medication (other than heartworm or flea preventative).
3. Bathing - Please do NOT bathe your pet within three days of the surgery date. Pets should be bathed with a veterinarian-approved shampoo only. Please call 561.686.3663, ext. 167 if you have questions.
4. In Heat/Nursing - Female cats and dogs must NOT be in heat at the time of surgery. Females must no longer be nursing and milk must have dried up.
5. Sores/illness - We will not perform surgery on your pet if it is ill, significantly overweight, or has sores/injuries.
6. Food/Water - DO NOT give food or water to your pet after midnight the night before surgery.
7. Leash/Carrier - Dogs must be on leash and cats in a carrier, box or wrapped in a towel when arriving for surgery.
8. Animals 5 years and older - For the safety of your pet you must provide proof of a physical examination with blood tests (chemistry profile, CBC) within the last six months by a private veterinarian prior to surgery. Documentation may be faxed to 561.472.8859. If your pet does not have a recent heart worm occult, there will be an additional $10.00 charge.
9. Appointment - Please bring your animal to the League between 7:30 a.m. and 8:00 a.m. on the surgery appointment date – you must wait with your pet until seen by a vet tech, please be prepared to wait. If you have not received a phone call from us within five days of submitting your application, please call us at 561.686.3663, ext. 167. An appointment for suture removal will be scheduled when you pick up your pet.
10. Pick-up - Your pet will spend the night and must be picked up between 7:30 a.m. and 9:00 a.m. the following day. There will be a $10.00 late fee for each pet picked up after 9:00 a.m.
11. The surgery fee of $25.00 (Cat) or $100.00 (Dog) is required in advance and is non-refundable. If your pet has not had a recent heart worm occult, there will be an additional $10.00 charge.
12. Microchip - A microchip will be provided for your pet for an additional $10.00. E-Collar - An e-collar will be provided for an additional $10.00
13. Please be aware that we will shave a small area of your pet’s leg where an IV will be inserted.
14. We urge you to follow these guidelines to avoid the inconvenience of re-scheduling your pet’s surgery. If you have any questions please call 561.686.3663, ext. 167.

Thank you for altering your pet! Along with numerous health benefits, you are helping to reduce the pet over population problem in Palm Beach County!