"*" indicates required fields DENTAL RADIOGRAPHSWithout dental radiographs (x-rays), more than 50% of all dental problems in cats will go undiagnosed. For this reason, full mouth radiographs are recommended for all dental patients. The cost has been listed on your estimate and is included in the high-end total. Please select how you would like us to proceed:* Yes, please proceed with full mouth dental radiographs. No, only take dental radiographs on teeth that are suspicious of disease. DENTAL EXTRACTIONSIt is difficult to thoroughly examine all aspects of the oral cavity until the cat is anesthetized. Once under anesthesia, we evaluate each individual tooth and the entire oral cavity for any problems that may need attention. Many cats need some form of additional dental surgery such as extractions. We realize that you may not have planned for these additional services. In the event we discover teeth that need to be extracted, please select your preference:* Yes, please proceed with extractions. You do not need to contact me. No, please contact me prior to any extractions. If you are unable to reach me, then proceed with recommended extractions. I understand that there will be additional charges related to the extractions. No, please contact me prior to any extractions. If you are unable to reach me, then do not proceed with any additional treatment. I understand that this may require additional anesthesia to address my cat's dental issues later. PAIN CONTROLPain control is imperative after dental extractions. You have an option of a long-acting opioid injection that lasts for 3 days or an oral opioid medication. Your cat may also receive an anti- inflammatory injection. Please select your preference: Zorbium- a long acting (4 days) topical application of buprenorphine. Possible side effects are hyperactivity, sleeplessness, paranoia and agitation. Transmucosal Buprenorphine - a twice daily oral medication. Side effects are possible but less likely since lower doses are given more frequently. Patient Name* Owner's Name* First Last I understand that the safety of my cat is the overriding priority. I understand that any price quote I have been given is an estimate and fi complications are involved, or the procedure is of greaterdimensions than anticipated, the price may be higher. I understand that by signing below, I agree to pay for all charges. incurred as such and will pay the balance ni full upon discharge of my cat.* I have read and understand.Printed Name* Signature* Reset signature Signature locked. Reset to sign again Date* MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.