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Surgery Appointment Policy Form
Thank you for choosing St. Louis Veterinary Center, we greatly appreciate it. Please fill out the form as accurately as possible.
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Surgery Appointment Policy Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 314-773-6400 for a faster response.

1. Cancellation/No Show Policy for Surgical Appointment
We understand that there are times when you must miss an appointment due to emergencies or obligations for work or family. In the event of a reschedule 24 hours or more in advance, your deposit will be applied to the next surgical appointment. If a cancellation accours 24 hours or more in advance, your one-hundred dollar ($100) surgery deposit will be refunded. If the surgery is not cancelled at least 24 hours in advance, your onehundred dollar ($100) surgery deposit will be retained and listed as a no show on your pets chart. No show clients are charged deposits at time of scheduling any future appointments with us.

2. Surgical Appointments
We understand that delays can happen however, we must keep the other patients and doctor on time. If a patient is not dropped off by 8:00am, we may have to reschedule/cancel the surgery. This is up to the Doctor's discretion.

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Release of Billing Information & Assignment of Benefits

By signing this form, I hereby authorize payment directly to St. Louis Veterinary Center for any surgical and/or medical benefits. I also authorize St. Louis Veterinary Center to file all
necessary papers and release any copies of medical records requested by my pet(s) insurance company or another veterinary facility.

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