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Dental Procedure Authorization Form

For cats scheduled for a dental procedure, please complete this form before the day of your appointment. The information provided will help us review treatment authorizations, discuss potential dental findings, and prepare for your cat's care.

PLEASE NOTE - You will be asked on the morning of surgery if your cat ate that morning. Your cat should be FASTED after midnight. Water is OK.

Does your cat take any medications?

This authorization form is valid for the scheduled date of my cat's dental procedure.

Anesthesia and Surgical Procedure Authorization

I am the owner or authorized agent of the animal described above and give consent for Felines First Veterinary Hospital to perform any necessary and advisable medical or surgical procedures, including dental treatment, for my pet’s health and well-being.


I understand that while the staff will exercise reasonable precautions and perform all procedures to the best of their ability, no guarantee of outcome can be made. I agree not to hold Felines First Veterinary Hospital or its staff liable in the event of illness, injury, or death, and I accept responsibility for payment in full at the time of discharge.

Preoperative Blood Screening

When anesthesia is required, we take every precaution to help ensure your cat’s safety. Despite careful monitoring, complications can arise—especially if underlying conditions like anemia, kidney dysfunction, or liver disease are present but undetected. These issues may not show up during a physical exam alone, which is why blood testing before anesthesia is so important.


To better assess your cat’s internal health and minimize risk during and after the procedure, a pre-anesthetic blood panel—including a chemistry profile, complete blood count, and electrolyte analysis—is required. If this testing has not already been performed, it will be completed on the morning of the procedure.


For cats that are aged 7 and above, due to increased risk with age, more comprehensive preanesthetic blood work and a heart screening test are required. This is with safety in mind.

My cat is:

Viral Testing and Heartworms

We strongly recommend a Snap Triple Test for all cats undergoing anesthesia. This test provides results within 15 minutes and screens for:


Feline Leukemia Virus (FeLV): Weakens the immune system and can increase anesthetic and surgical risks.


Feline Immunodeficiency Virus (FIV): Similar to FeLV, FIV impairs immune function and may affect recovery.


Heartworms: Though more common in dogs, heartworm disease can cause serious complications in cats, especially under anesthesia.

Testing allows us to take appropriate precautions and provide the safest possible care during your cat’s procedure.

Intavenous Catheter and Fluids

An intravenous (IV) catheter is recommended for all surgical patients to provide immediate access to the bloodstream for medications and emergency intervention if needed.


IV fluids administered through the catheter help maintain blood pressure, support vital organ function, keep your cat hydrated, and aid in drug clearance after anesthesia.


All cats undergoing dental procedures at our hospital will receive pain medication, an IV catheter, and intravenous fluids during the procedure. These services are included in your treatment estimate.

Dental Extractions Selection

Dental procedures—including both simple and surgical extractions—carry certain risks, such as broken roots, bleeding, dry sockets, tissue damage, or, in rare cases, jaw fractures. While we make every effort to anticipate and prevent complications, some issues may not be evident until your cat is under anesthesia.

I understand that my estimate is based on my cat’s examination findings prior to anesthesia. Additional dental disease or treatment needs, including extractions, may be identified once my cat is anesthetized and dental radiographs are performed.

If additional treatment outside of my approved estimate is recommended, I prefer:
Proceed with any additional medically recommended dental treatment up to the amount listed below without contacting me.
Contact me before performing any additional treatment not already included in my approved estimate.

Post-operative Therapeutic Laser Treatment

Therapeutic laser treatment (photobiomodulation) uses light energy to stimulate cellular healing, reduce inflammation, relieve pain, and promote faster tissue repair. This non-invasive treatment can be especially helpful in improving comfort and recovery.

Laser Therapy Selection:
I authorize laser treatment if extractions are performed. ($14.50)
I would like to decline laser therapy.

Oral Microbiome Health Test

We are pleased to offer the Oral Microbiome Health Test, a cutting-edge diagnostic tool that helps us understand your cat's unique oral health at a deeper level. This test involves a simple in-clinic sample taken during the dental procedure.


What it does:


Identifies hundreds of types of bacteria in your cat's mouth, including those linked to dental disease and other health issues.


Detects imbalances in your cat's oral bacteria that may contribute to problems.


Provides a customized report with recommendations for diet, supplements, or other interventions to improve your cat's oral health plan.


Can be used annually or to monitor the effectiveness of your cat's dental care routine.


*Results will take approximately 15-20 days.

Oral Microbiome Testing Selection:
I would like to have my cat's oral microbiome health tested at this time at a discounted cost of $170.50. (*$25 discount for sedated procedures)
I would like to decline this test.

Emergency CPR Selection

In case of cardiac and/or respiratory arrest, it's very important for our veterinarians to know how to provide the best quality care based on your wishes. This allows our staff to immediately respond to an unexpected and potentially life-threatening situation. These wishes are asked of every client that has their pet stay with us at our hospital, regardless of health status.

To follow your wishes and provide the best possible care while your pet is with us, we ask that you choose a resuscitation code.

In the event of cardiac or respiratory failure:
(CPR) I wish to have any/all efforts at resuscitation performed. Techniques may include (but are not limited to) basic CPR, IV medications, ventilations, and/or surgical techniques. I realize that additional costs may be incurred and I agree to pay these costs in full during the time of treatment/pick-up.
(DNR) I DO NOT wish for resuscitation efforts to be performed on my pet.
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