I am the owner or the authorized agent for the owner of the animal described above, and I have the authority to execute this consent. My signature below certifies that I am over eighteen years of age.
I have been informed that there are certain risks and complications associated with sedation, anesthesia, and/or any
operation/procedure and that the risks/complications have been explained to me. I further understand that during the course of the operations or procedures, unforeseen conditions may arise that may necessitate the performance ofadditional procedures deemed necessary by the veterinarian. I am encouraged to discuss any concerns I have about these risks with the attending veterinarian before the procedure is initiated. I authorize the use of appropriate anesthesia and pain relief medication as needed before, during or after the procedure. I have been informed that there are risks associated with the use of any medication.
The nature of these operations or procedures has been explained to me and I understand what will be done. I am aware that the practice of veterinary medicine is not an exact science and, thus, there are no guarantees for successful treatment. I have been encouraged and given the opportunity to discuss any questions I may have regarding my pet's medical care and my questions have been answered to my satisfaction. I accept that my financial obligations remain regardless of the outcome.
I have read and understand this authorization and hereby accept and agree to the terms of the consent for treatment.
Did patient eat this morning?
Do you approve of Pre-Op Bloodwork?
Dental Extraction if needed:
Vaccinations: Vaccinations are for the protection of your pet, (Dogs: Rabies, Dhpp, Bordetella, Heartworm Exam and Fecal) (Cats: Rabies, FVRCP, and Fecal) we cannot make exceptions to vaccination requirements. If proof of vaccination is not on file or provided from another veterinarian, the pet will be vaccinated and examined at the owner's expense on the arrival date, and has higher risk of contracting an illness during their stay.
*Are there any other services the patient needs while under anesthesia?
CPR: In the event that the patient should experience cardiac or respiratory arrest while being hospitalized today, do you give consent for resuscitative efforts to be initiated until you can be contacted about the patients status?
Best Phone number to reach you today: (7am-3pm)