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Procedure Consent Form

Save time at your upcoming surgery appointment. Complete your required procedure consent form online before your visit.

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Procedure Consent Form

Fill out this form in advance of dropping off your pet on surgery day to save time.

Please fill in the date of the procedure being performed.
Please indicate the name of the procedure we will be performing for your pet today.
Procedures usually require that your pet not receive food or water prior to their appointment. Please tell us the last time you gave your pet any food or water.
Please list any medications your pet is currently taking and the last time they were given.
The doctor will perform a complete physical exam on the day of surgery. Bloodwork can be performed to check kidney and liver values prior to undergoing anesthesia. The cost of this bloodwork is $202.00. All pets 7 years or older must undergo this testing. Would you like your pet to have a pre-anethetic blood screen today?
Would you like us to microchip your pet while under anesthesia? Microchipping increases the likelihood that you pet will be found if lost. Cost to implant microchip is $69.00.
I understand that during the performance of the foregoing procedure(s), unforeseen conditions may be revealed that necessitate an extension of the foregoing procedure(s) than those set forth above. Therefore, I hereby consent to the performance of such procedure(s) as are necessary and desirable in the exercise of the veterinarian’s professional judgment. I also authorize the use of appropriate anesthetics and other medications, and I understand that Hospital support personnel will be employed as deemed necessary by the veterinarian. I have been advised as to the nature of the procedures or operations. I have been able to ask questions and have been informed of the risks involved. I understand that anesthesia, sedation and or surgery have inherent risks including death. Due to the nature of the medicine, I also realize that results cannot be guaranteed. I have read and understand this authorization and consent to all of the above.