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Referral Request Form

Thank you for supporting Second Chances Veterinary Care. We are an affordably priced outpatient surgery, procedural, and urgent care-focused veterinary clinic.

Appointment

Referral Request Form

Fill out this form if your pet needs to have a ROUTINE spay or neuter procedure performed [DO NOT use this form for emergency procedures including PYOMETRA].

Read: What is the Best AGE to Spay or Neuter Your Pet for additional information on the IDEAL AGE for Spay or Neuter Surgery.

Read: Your Pet’s Upcoming Anesthetic & Surgical or Dental Procedure for additional information on how to prepare your pet for their procedure day and what to expect as a pet parent when visiting Second Chances Veterinary Care.

Drop off will be between 7:30-9:00a – please arrive on-time. Expect drop off to take between 15-30 minutes – plan accordingly. **Late arrivals could lead to rescheduling of your pet’s surgery, loss of deposit, & late arrival fee**

Discharge times are between 3-5:30p unless directed otherwise. **A $50 late fee will be assessed to any late-pick up after 5:30p** We do not have capability to keep patients overnight.

ALL SPAY & NEUTER SURGERIES INCLUDE…
Office visit; staff services; brief surgical exam; hospital occupancy; premedication/oral sedation; anesthesia, surgery, local/regional anesthesia; and 24-48hrs* of pain medication

Pain medications included in the cost of surgery:
ALL SPAYS – 48-hrs included [injection(s) during surgery & NSAID TGH]
NEUTER – Cats/Puppies <12-weeks. 24-hrs included [injections during surgery +/- NSAID TGH]
NEUTER – All dogs > 12-weeks. 48-hrs included [injection(s) during surgery & NSAID TGH]
NSAID (Non-Steroidal Anti-Inflammatory Drug). TGH (To Go Home)

**E-collars; post-surgical suits; sedatives; and additional pain medications are available for an added fee**

The primary method of contact from the clinic is via TEXT and EMAIL. Please plan accordingly.
A cell phone #(s) is required for the primary contact number when available. Please list any additional phone numbers where the staff can reach out if questions. The primary method of contact from the clinic is via TEXT and EMAIL. Please plan accordingly.
A physical examination by the doctor is required on all pets > 5 years of age and always advised for any pet. Lab work (bloodwork) is STRONGLY RECOMMENDED for all pets; especially in pets > 5 years. **Additional Charges Apply**
Spay and neuter prices are based on the pet's weight. All pets are weighed when admitted for surgery. The weight recorded on the DAY OF SURGERY is the weight used for pricing**
Check ALL possibilities. **Additional charges apply and will be determined at the time your pet is in surgery - prepare accordingly**
DOGS: Bulldogs (French*, English*), Boxers, Shih tzu's, Pugs, Pekingese, Boston Terriers, Affenpinscher, Brussels Griffon, Japanese Chin, Lhasa Apso, and others CATS: Persian, Himalayan, Scottish Fold/Shorthair, Burmese All brachycephalic breeds will be REQUIRED to have an IV Catheter placed for the procedure **Additional charges may apply for IV catheter, fluids, and additional anesthetic monitoring during the procedure and recovery** You may want to also consider additional ADD ON procedures that many brachycephalic pets may benefit from that can be added to your SPAY/NEUTER surgery.
Great Dane, Saint Bernard, Weimaraner are the top 3 at-risk breeds for GDV. Other at-risk breeds include Standard poodle, Irish setter, Gordon setter, Irish wolfhound, Newfoundland, Akita, German shepherd, Great Pyrenees, Doberman pinscher, Collie, Rottweiler, Bernese Mountain dog, boxer, and [English] mastiff. If your pet is one of [or mixed with] the breeds listed above, they may benefit from a PROPHYLACTIC GASTROPEXY.
Great Dane, Saint Bernard, Weimaraner are the top 3 at-risk breeds for GDV. Other at-risk breeds include Standard poodle, Irish setter, Gordon setter, Irish wolfhound, Newfoundland, Akita, German shepherd, Great Pyrenees, Doberman pinscher, Collie, Rottweiler, Bernese Mountain dog, boxer, and [English] mastiff. If your pet is one of [or mixed with] the breeds listed above, they may benefit from a PROPHYLACTIC GASTROPEXY. Please read PROPHYLACTIC GASTROPEXY for more information about Bloat & GDV in large breed dogs.
Include all MEDS/SUPPLEMENTS your pet is currently taking or has recently taken in the past month
Heart murmur, kidney disease, masses, allergies, allergic reactions...Include previous surgeries/procedures (mass removal, eye surgery, hernia repair...) as well as treatments that have been administered.
**Additional charges apply** Vaccinations can help protect animals from life threatening diseases, and some vaccinations, such as Rabies, are required by Colorado law. Proof of RABIES vaccine is REQUIRED prior to surgery. If you cannot show proof of RABIES vaccination on/before the date of surgery, a rabies vaccine will be administered the day of surgery and charged accordingly. Vaccinations can be safely given to the animal the same day of certain surgical procedures, including spay/neuter; and this is much safer for your pet than remaining unvaccinated. Be aware that an animal’s immune system creates a stronger response and immunity when vaccinations are not given on the same day of surgery as it would when given at least 2-weeks prior to or 2-weeks after any sedative, anesthetic, or surgical event.
**Additional charges apply**
We believe providing & giving animals the most STRESS/FEAR FREE and PAINLESS experience as possible while at the clinic. All pets will receive PRE-MEDICATIONS including SEDATIVES/ANTI-ANXIETY/PAIN MEDICATIONS upon arrival at the clinic. Having a pre-surgical evaluation qualifies you for a SURGERY CREDIT/REWARD which can be used the day of surgery [up to $20 off the equivalent amount of additional products or services including a nail trim, anal gland check/expression, vaccines, E-collar purchase, medications, or additional surgical service] This evaluation will be used to get an accurate pet weight, draw pre-operative labwork, administer any wanted vaccines, confirm previous medical records/history and get MEDICATIONS to give the NIGHT BEFORE, the MORNING OF, and AFTER the surgery. This will benefit your pet because they will be LESS ANXIOUS or NAUSEATED prior to their arrival for their hospital stay AND it will SAVE YOU MONEY.
**Additional EXAM, TREATMENT & MEDICATION charges apply** A doctor CONSULTATION (in person/by phone) is charged separately from a doctor's examination. Only a BRIEF/CURSORY examination to determine if patient is fit for anesthesia/surgery is INCLUDED** Mark OTHER if the answer is YES and DESCRIBE in as much detail as possible both the HISTORY (who/what/where/when/how/why) and CLINICAL SIGNS/SYMPTOMS/OBSERVATIONS/BEHAVIORS below
If YES, write the Clinic name/doctor name/clinic phone number & clinic email on the "Other" line. You will be asked to UPLOAD all medical records below
Mark OTHER if the answer is YES and DESCRIBE in detail. (ie: I need someone to describe how payments work)
Click or drag files to this area to upload. You can upload up to 20 files.
Please upload ALL patient medical/adoption/purchase records including showing VACCINATIONS and previous MEDICAL CONDITIONS/ HISTORY from any veterinarian you have visited in the past 2-years. * As the pet owner it is YOUR responsibility to provided ALL medical records AND your pet's information including but not limited to your pet's previous medical history, current/recent medications, recent/past lab work results, and current vaccination status AT LEAST 24-HOURS prior to the day of the scheduled procedure. If you are having difficulty with any of the forms, uploading your pet's medical records, or you have additional questions, please reach out to the hospital: info@2ndchancevet.com or 303-955-4576 (chat/text/call)