SNIP Clinic Admission Procedures

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Thank you for choosing HAWS’ SNIP Clinic for your pets’ spay/neuter procedure.

Please fill out the SNIP Clinic Admission Form prior to your scheduled appointment. We prefer forms be submitted a minimum of 72 hours before your appointment time. An appointment MUST be scheduled before submitting this form.

Completing your paperwork before your scheduled appointment time will ensure a smooth check in process the morning of your pet’s procedure.

*If you have not yet scheduled an appointment, please call 262-542-8852 before filling out the form below.

SNIP Clinic Admission Form

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1Personal Information

2Animal Information

3Requested Services

4Waiver and Release

Please enter the date of your already scheduled SNIP Clinic appointment. *

**Forms must be submitted a minimum of 72 hours prior to your scheduled appointment.

Owners's Name *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone *

Secondary Phone

Email *

Animal's Name *

Breed & Color *

Gender *

Age (At time of surgery) *

Has your animal been to a veterinarian within the last 30 days? *

If yes, what was the reason for the visit?

Regular Checkup
Vaccines
Sick/Injured
Other

Does your animal have any current medical conditions (including sneezing, coughing, vomiting or diarrhea)? *

If yes, please describe:

Is your animal taking any medications (including flea/tick treatments, heartworm preventative, insulin, thyroid or steroids)? *

If yes, please describe:

Vaccination Records

Click or drag a file to this area to upload.

Rabies certificate is required before we can treat your animal. If your animal does not have a current rabies vaccination, one will be given at the time of the appointment. You may bring a rabies certificate at the time of your appointment; tags cannot be accepted as proof of rabies.

Additional Vaccination Records

Click or drag a file to this area to upload.

I would like the following services and agree to their fixed price. *

Spay/Neuter (Price Quoted)
1 year Rabies Vaccine ($15)
Microchip ($15)
Cryptorchid (per testicle) ($40-$100)
Umbilical Hernia Repair ($35-$40)
Nail trim ($5)
Cone to Prevent Post-Op Licking ($15+tax)
Extract retained deciduous teeth ($10 per tooth)
Revolution - single dose for cats only ($15)
FeLeuk/FIV/HW Test - cats only ($30)
Heartworm Test - 6mo+ dog only ($15)
Brachycephalic Pet - Additional $50

I would like Heartworm Prevention - 6 pack for dog only ($30-$50) *MUST have negative test at HAWS. *

Yes, I would like Heartworm Prevention (1 box)
Yes, I would like Heartworm Prevention (2 boxes)
No, I would not like Heartworm Prevention

To prevent future dental issues, we recommend the removal of remaining deciduous (baby) teeth for dogs 6 months or older. If we discover deciduous teeth while your dog is in our care, do we have your consent to remove the teeth at $10 per tooth? (copy) *

Yes, remove the deciduous teeth
No, do not remove the deciduous teeth

Trazadone is a mild sedative that we can prescribe and dispense to dogs to help them remain less active during the healing phase. It is most helpful during the 10 days postop when dogs need less activity to help the surgical site heal. Postop instructions will include leash walks only, with no running and jumping for at least 10-14 days. This inactivity is to help the incision heal. Normal activities will lead to discomfort and the dog more prone to infection from licking at the incision site. If your dog is quite energetic, and you believe keeping them inactive will be difficult, you may want to consider asking for this at check in. It is not included in the spay price, as not all dogs will need it. Cost can range $2-$24 depending on the size of the dog. Do you want your dog to be given Trazadone? *

Yes, I would like my dog to be given Trazadone
No, I would not like my dog to be given Trazadone