Arden Animal Hospital

1823 Fulton Avenue
Sacramento, CA 95825

(916)485-5412

www.ardenanimalhospital.com

Dental Release Form

Dear Clients,

In case of the additional/non-emergency procedures that become necessary, I would like you to: (required)

Proceed with any treatment deemed necessary including extractions, x-rays and antibiotics
Proceed with necessary treatment up to a certain dollar amount (chosen below)
Try to phone first, if you cannot reach me on the telephone you may proceed with any procedures deemed necessary
Do nothing unless you reach me by telephone


Proceed with necessary treatment up to $____ additional cost (if this selection was chosen above)

Telephone number(s) I can be reached at between 9am-6pm today: (required)


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