Surgery Consent Form

Name(Required)
Pets name(Required)
Species(Required)
Is your pet(Required)
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I understand that during the performance of the foregoing procedures there are inherent risks and unforeseen conditions that may be revealed. If necessary, an extension of the foregoing procedures may be performed. Therefore, I hereby consent to and authorize the performance of such procedures deemed necessary and desirable by the veterinarian’s professional judgment. I also authorize the use of appropriate anesthetics and other medication, and I understand that hospital support personnel will be deemed necessary by the veterinarian. Although this facility attempts to minimize the risk involved during anesthesia, there is always risk in anesthetizing an animal. One way to lower risks involved with anesthesia is to have the “Pre-Anesthetic Blood Testing Option” (listed below) performed on the animal prior to surgery. I realize that there are inherent risks involved and results cannot be guaranteed.
If you pets heart stops during the procedure, life saving efforts using CPR and injections can be administered if desired.(Required)

Chemistry/ Electrolytes Panel ~ Additional

For the added safety of your pet, we recommend a computerized pre-anesthetic blood profile screening. The information gathered from the screening allows us to more thoroughly evaluate the liver, kidneys, and blood sugar of your pet prior to surgery.(Required)

Complete Blood Count ~ Additional

A CBC measures the red and white blood cells and platelets. It helps us evaluate whether your animal has an active infection, is anemic, or could potentially have clotting issues.(Required)

Microchip Option ~ Additional

Our HomeAgain microchip application and registration makes it easier to find your pet if they are lost.(Required)

Pain Medications ~ Additional $10.00-$30.00 (depending on animal’s size)

Our HomeAgain microchip application and registration makes it easier to find your pet if they are lost.(Required)

Fasting

Our HomeAgain microchip application and registration makes it easier to find your pet if they are lost.(Required)
In the event your female animal is in heat or pregnant, the cost of surgery will go up. If during surgery we find your female animal is pregnant, please indicate your choice below:(Required)
Signature:(Required)
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