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Hours & Contact
Hospital Hours:
Mon - Thurs: 8:00am - 7:00pm
Fri: 8:00am - 5:00pm
Sat: 8:00am - 12:00pm
Hospital Contact Info:
Phone: (262) 846-6006
Fax: (262) 781-5278
[email protected]
Pet Resort Hours:
Mon - Fri: 6:30am - 6:00pm
Sat and Sun: By Appointment Only
Pet Resort Contact Info:
Phone:
(262) 384-6771
[email protected]
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Dental Consent
CONSENT FORM DENTISTRY SERVICES
Patient Name
First Client Name
First
Last
Additional procedures to be performed
We do not know the extent of oral disease present in your pet's mouth until a complete oral exam and full mouth radiographs have been taken under anesthesia.
Therefore, I give permission for oral surgery for extractions and gingival lesions/masses and pain medications if necessary up to the upper end of the treatment estimate.
Yes
No
CALL ME FIRST
I wish to have SANOS dental sealant applied to my pet's teeth today.
Yes
No
I received a treatment plan for today's procedure within the range of
$1-$500
$500-$1000
$1000-$2000
$2000-$3000
$3000-$4000
$4000-$5000
$5000
Name to call with update:
First
Last
Phone
Date
To receive updates today on my pet, I prefer a:
Text
Phone Call
Brook-Falls Veterinary Hospital & Exotic Care
Additional Questions
Do you wish to have your pet receive a Home Again Microchip?
Yes
No
Already Has
Has your pet eaten anything at all in the last 12 hours?
Confirm
No
Has your pet been given any medications, supplements, or treatments during the past 7 days?
Yes
No
Has your pet ever had a past anesthetic event that you thought went Poorly?
Yes
No
Do you have any questions for the Doctor this morning?
Yes
No
Do you need any medications refills today?
Yes
No
Do you think you will be able to brush your pet's teeth once daily long term?
Yes
No
pet toothpaste
How many times a week?
oral rinse
How many times a week?
dental diet
How many times a week?
dental treats
How many times a week?
dental chews
How many times a week?
dental food additives
How many times a week?
dental water additives
How many times a week?
Which product would you like to receive at no charge with your procedure today?
Tooth paste
Dental_treats
Dental chews
Dental food additive
Dental water additive
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