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Adopt
Services
Ways to Give
Events
Who We Are
Contact
- Hours
- News
- Report Abuse

SNIP Clinic Admission Procedures

Be a part of the HAWS community for pets and their people. Join our pack!

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 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

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

**Forms must be submitted 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? *

Yes
No

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)? *

Yes
No

If yes, please describe:

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

Yes
No

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.

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.

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) ($30-$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)
Heartworm Prevention - 6 pack for dog only ($30-$50) *MUST have negative test at HAWS*
Brachycephalic Pet - Additional $50

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? *

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

SNIP Clinic Waiver and Release

I acknowledge that I have read, understand and agree to the following statement. *

HAWS uses qualified staff and approved materials for all procedures performed. It is important for you to understand that the risk of injury or death, although extremely low, is always present, just as it is for humans who undergo surgery. Please carefully read, and ensure you understand all of the information on this agreement before signing your name.

I acknowledge that I have read, understand and agree to the following statement. *

I, being lawfully authorized to make decisions on behalf of the animal named/described above (the "Animal"), hereby request and authorize HAWS, including its affiliates and each of their employees, volunteers, veterinarians and/or other agents (collectively, "HAWS Parties"), to receive, transport, prescribe for, treat and/or administer vaccinations and/or perform an operation on the Animal.

I acknowledge that I have read, understand and agree to the following statement. *

I certify that the Animal has not bitten anyone in the last ten (10) days.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that the operation I have elected presents some hazards, and that injury to, post-operative infection in, or death of, the Animal may conceivably result, for there is some inherent risk in the procedure and in the use of anesthetics and drugs provided for the procedure, as well as in any vaccines used. I understand that general anesthesia will be administered to the Animal for surgery. I understand and accept these risks to the Animal.

I acknowledge that I have read, understand and agree to the following statement. *

I understand the inherent risks of failing to maintain current vaccinations and waive all claims arising out of, or connected with, the performance of this operation due to such failure. I understand, in particular, that if the Animal develops kennel cough or other upper respiratory infections after surgery, I am responsible for treatment at my own cost.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that HAWS and/or any HAWS Party has the right to refuse any service and/or procedure to any animal for any reason, including, but not limited to, situations where surgery is deemed a health or safety risk. Such refusal is at the sole discretion of the attending veterinarian.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that a pre-surgery exam will be performed on the Animal when possible, but that there are times, in the attending veterinarian's sole discretion, when such an exam may only be performed after the Animal has already been sedated or anesthetized. I understand that the Animal will not receive pre-operative bloodwork at HAWS. If I choose for the Animal to have such bloodwork, I understand that it must be performed at a full-service veterinary clinic.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that some factors significantly Increase surgical risk, including, but not limited to, pregnancy, heat, and diseases such as feline immunodeficiency virus {"FIV"), feline leukemia virus ("Feleuk"), heartworms, obesity, blood clotting disorders, endocrine diseases, and senior animals. I further understand that certain breeds such as Dobermans are predisposed to diseases that put them at a greater risk during surgery.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that if the Animal is an acceptable surgical and/or vaccination candidate, surgical procedures and/or vaccinations will be performed regardless of the Animals gender and/or medical condition, including but not limited to, pregnancy. I understand if the Animal is pregnant, the pregnancy will be terminated at surgery.

I acknowledge that I have read, understand and agree to the following statement. *

If an unforeseen event/emergency situation occurs or a medical condition is discovered that requires urgent immediate medical treatment, I consent that the attending veterinarian may perform such treatment, or transport the Animal to.another veterinarian for the provision of such treatment at my expense, without seeking additional authorization or consent from me.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that my further consent will be required for non-emergency treatment but in cases where I am not reachable, I consent to the repair of an open umbilical hernia at an additional charge of $35-40, and/or agree that if one or more of my male animal’s testicles are not descended (cryptorchid) I will be charged $30-100 per undescended testicle, depending on location. This will be due at the time of pick-up.

I acknowledge that I have read, understand and agree to the following statement. *

I understand that if I do not show proof of a current rabies vaccination, HAWS will automatically administer a one year rabies to my animal.

I acknowledge that I have read, understand and agree to the following statement. *

Animals spayed and neutered will receive a small tattoo on his/her underside to show that he/she has been sterilized.

I acknowledge that I have read, understand and agree to the following statement. *

Drop off is between 7-8 am and pick up time is between 2-3:45 pm. A $15 additional charge will be applied if dropping off or picking up after clinic hours. All pets must be on a leash or in a carrier; a $5 fee will apply if one is provided to you.

Electronic Signature *

Important appointment reminders:

Drop off is between 7-8 am.
Pick-up is between 2-3:45 pm.
Pets scheduled for surgery should not be fed after 9 pm the night before; water is ok.
Dogs cannot be spayed while in heat.

Help us continue our mission of ensuring the entire community treats animals and one another, with respect.

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HAWS is a 501(c)(3) non-profit organization.
701 Northview Road, Waukesha, WI 53188 | 262-542-8851
License #267280-DS | EIN #39-6108644