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Suffield Veterinary Hospital

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Pre-Examination History and Consent Form

  • Please complete the information below so we can keep our records up to date.


  • Dog:


  • Cat:


  • Dog or Cat:


  • Diagnostics and Treatment Consent

    I hereby authorize Suffield Veterinary Hospital to perform professional services that are, in their opinion, advised for treatment and maintenance of my pet’s health and wellbeing. I also authorize the following, if necessary, to be performed:

  • Pre-Anesthetic Blood Work Consent

    If your pet is here for a procedure involving sedation/anesthesia, please read the following carefully and indicate your preference by signing below.

    A complete physical exam will be performed prior to any anesthesia/sedation to assure your pet’s health and safety. Along with the physical examination, we strongly recommend a few simple laboratory tests to determine your pet’s ability to tolerate the procedure and assure that it is a low-risk patient. The screening includes a complete blood count and a chemistry profile. This will demonstrate your pet’s ability to metabolize the sedation/anesthesia properly.

    *ALL PETS 5 YEARS AND OLDER MUST HAVE PRE ANESTHETIC BLOODWORK DONE BEFORE ANY SEDATION/ANESTHESIA. EVERY DOG MUST HAVE AN ANNUAL HEARTWORM TEST PRIOR TO ANESTHESIA*

    We have the latest in laboratory equipment/technology which makes this procedure quick, easy, and inexpensive. We are proud to be able to offer this benefit to our clients. There is an additional charge of $85.60 for the screening and we feel it is an important step to ensure your pet’s safety and level of risk.

  • Website and Social Media Release

    I hereby grant Suffield Veterinary Hospital permission to use the likeness of my pets (s), should they so choose, in a photograph, video, or other digital reproduction in any and all of its publications, including website and social media entries, without payment, compensation, or any other consideration.
  • After Hours Pick-Up Policy

    Please note our business hours and make sure to pick up your pet prior to closing. If you pick up your pet after we close, you will be charged a late pick up fee of $50.00. If you are more than 30 minutes late, your pet will stay overnight at SVH and an appropriate overnight charge will be added to your invoice, in addition to the $50.00 late fee.
  • Payment for Products, Medications and Services Rendered

  • I am the owner or agent of the aforementioned pet, am at least 18 years of age, and am competent to contract in my own name. I have read this document in its entirety before signing below and I fully understand all of the content in this document and its meaning. I fully understand the impact of signing this release.

Office Hours:

  • MON: 7:30am – 6:00pm
  • TUE: 7:30am – 6:00pm
  • WED: 7:30am – 5:00pm
  • THU: 7:30am – 6:00pm
  • FRI: 7:30am – 5:00pm
  • SAT: 8:00am – 1:00pm
  • SUN: CLOSED
Call Us: (860) 668-4041

Our Veterinary Office

577 East St. South
Suffield, CT 06078

Request an Appointment

  • Please complete the following form to request an appointment. Please also note that availability will vary depending on your request. Your appointment will be confirmed by phone by a member of our staff. Thank you!
  • This field is for validation purposes and should be left unchanged.

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Suffield Veterinary Hospital

Our Location

Suffield Veterinary Hospital

Phone: (860) 668-4041 Address: 577 East Street S, Suffield, CT 06078 | Fax: (860) 668-4785

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