contact-image

Anesthesia Consent Form (Under 5 Years)

Complete your required forms online from any device at any time before your visit.
Get Started
paw-bg

Consent For Anesthesia And Surgery (Under 5 Years Of Age)

Pre-anesthetic blood work: Pre-anesthetic blood work is strongly recommended for all patients undergoing anesthesia. A simple blood test performed in-house will tell us about your pet’s liver and kidney function and allow us to tailor our anesthetic protocol to your pet. Our minimum testing is $97.40 above the cost of surgery, anesthesia, and vaccinations.

REASONABLE PRECAUTION WILL BE USED AGAINST INJURY, ESCAPE, OR DEATH OF YOUR PET. THE CLINIC AND STAFF WILL NOT BE HELD LIABLE FOR PROBLEMS THAT DEVELOP PROVIDED REASONABLE CARE AND PRECAUTIONS ARE FOLLOWED. I UNDERSTAND ANY PROBLEM THAT DEVELOPS WITH MY PET WILL BE TREATED AS DEEMED BEST BY THE STAFF AND VETERINARIAN(S) AND I ASSUME FULL RESPONSIBILITY FOR THE TREATMENT AND EXPENSE INVOLVED. I AGREE TO PAY FOR SERVICES RENDERED AT THE TIME THEY ARE COMPLETED. I WILL BE HELD RESPONSIBLE FOR REASONABLE COSTS INCURRED ON COLLECTION OF SAID FEES, SHOULD SUCH ACTION BE NECESSARY.

Clear Signature

Please indicate if your pet requires any vaccinations or deworming: