You’ve made an appointment for a treatment where you’re animal needs to be sedated. Please fill in this form before the appointment.

    Your data

    Data of your Pet

    Does your pet have any diseases?
    Drinks a lotPees a lotDiarrheaVomitingJoint problemsLiver diseaseDiabetesRenal problemsHeart murmurHeart DiseaseEpilepsySpecial dietNone of the above

    For the most optimal wound healing your pet shouldn't lick the wound and/or the stitches. In case your pet licks the wound we advice a collar or Medical Pet shirt. You can get these at an extra charge, collars cost €7,- to €16,- and €33,- for a large dog, a Medical Pet Shirt costs €30,- tot €35,-. What do you prefer?
    CollarMedical Pet ShirtNo preferenceNot applicable

    For older dogs, cats and rabbits we recommend to do a preanaesthetic blood test. Additional costs are €104,35 (instead of the normal €129,35). Would you like us to run the blood test? The check provides us with extra information about your pets health: kidneys, glucose, liver and inflammation values. If we find any abnormalities, we'll be be able to adjust the anaesthesia to make sure your pet gets the safest treatment. A bloodcheck is also recommended if your pet is sick or looses weight unintentionally.
    YesNoPlease inform me

    About the surgery

    What's the date of the procedure? Remember dogs and cats shouldn't at least 12 hours before the surgery. Drinking water is allowed. Rabbits and rodents should keep on eating and drinking up until the surgery.

    Do you know about the risks of the procedure? No anesthesia is without risk. We'll do our best to choose the safest way of anesthesia. When in doubt about your animals health, please let us know.
    YesNoPlease inform me

    Do you know the costs of the procedure? Standard prices are shonwn on our website www.dzeh.nl/tarieven. For prices of other procedures, please contact the clinic.
    YesNo

    Would you like to have your pet microchipped during the procedure? The additional costs are €42,75.
    YesNo

    The operating room is visible from our entrance. We can close it to prevent visitors from watching the surgery. Do you want it closed or open?
    OpenClosedNo preference

    With our webcam service www.dzeh.nl/webcam you can watch your pet in recovery (not during surgery). Do you want your pet on the webcam - if available?
    YesNoNo preference

    If we make a nice picture of your pet, do you agree if we use it on social media?
    YesNo

    Is there anything else you would like to discuss during your visit?