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Surgery/Anesthesia Consent Form

Your pet’s safety is our priority—please fill out this consent form so we can provide the best care during their surgery and anesthesia.

Procedure(s)

CONTACT INFORMATION

Where can you be reached throughout the day in case of Emergency or the Doctor needs to discuss your pet condition

Recent Patient History

RECENT HISTORY- within the last 2 weeks

MEDICATION/ SUPP'S

 

External Parasites

Pets found to have fleas or ticks upon presentation will be treated and charged accordingly

Pre-Anesthetic Bloodwork

Labwork appropriate to your pet's age and health status has been performed or will be performed prior to giving any medications.

For Cats Only

Anesthesia/Resuscitative directive

Ancillary Procedures

Clear Signature

What is 4+4?

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