Morning of Surgery/Procedure Intake Form

Please complete this form on the morning of your pet’s surgery or procedure, before their intake appointment at our clinic.

 

 

All questions in this form (including name, contact details, and COVID-19 screening) refer to the person accompanying your pet to the appointment.
We will email your pet's discharge instructions to this address.
 

If yes, please arrange for someone outside your home to bring your pet in on your behalf, and call us right away if that is not possible, so that we can make a plan together. This is essential so that we can protect our team members and ensure that we can stay open to help pets in need.
 

If yes, please provide details.
If yes, please provide details.
If yes, please provide details.
If yes, please provide details.
If yes, please provide details.
If yes, please list your questions below
Do you understand the cost estimate you have been given for your pet's procedure, and give consent for us to proceed today?*
All surgeries and many procedures (including ultrasounds) require one or more areas of your pet's fur to be shaved in order to prevent infection or perform the procedure. Do you understand and give consent for us to proceed today?*
If you do not answer Yes, we can NOT perform your pet's surgery or procedure.
Can we take pictures of your pet while they are here with us today, for possible use on social media, our website, etc?*

If yes, and you do not already have a master insurance claim form on file with us, please provide your insurance company name and policy number so that we can submit your pet's claims for you. If not, but you would like to learn more, leave us a note here and ask the surgery technician at your intake appointment. We can give you information on several reputable companies and arrange a free trial (subject to age limits) to protect your pet while you research and make a decision.

Do you want your pet to receive a microchip today?*
A microchip has a unique identification number that links to your contact information and can be scanned by any vet clinic or shelter if someone finds your pet. It can help your pet get back home to you if they ever get lost or stolen, escape, or go missing during an emergency like a car accident or fire. The price includes the microchip (about the size of a grain of rice), implantation between your pet's shoulders, and initial registration. This is a one-time cost, and a microchip lasts for your pet's entire life.
Security Question*
 
 
 

Practice information

Roncy Village Veterinary Clinic

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  • Mon
    8:00am – 7:00pm
  • Tue
    8:00am – 7:00pm
  • Wed
    8:00am – 1:00pm & 3:00pm – 7:00pm
  • Thu
    8:00am – 7:00pm
  • Fri
    8:00am – 7:00pm
  • Sat
    8:00am – 2:00pm
  • Sun
    Closed (Sundays & Holidays)

After-Hours Emergencies

Please call:

416-784-4444
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Find us here:

215 Roncesvalles Avenue Toronto, Ontario M6R 2L6
get directions with Google Maps
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For after-hours emergencies, please call:

416-784-4444