Pre-Anesthetic Consent Form

Prior to acceptance for a scheduled procedure, answers to the following questions are important to ensure the safety of your animal and appropriate services are rendered.
  • Date Format: MM slash DD slash YYYY
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    Histopathology is to identify the tissue type and increase the chance of a positive diagnosis. This cost is additional.
    Prior to surgery, an effort is made to externally palpate for a normal abdomen and uterus. If there is any indication of possible abnormality or pregnancy, this predetermination will give us direction on how to proceed.
    If your pet is on medication, please list ALL types and when last given.
    Medication for post operative pain is highly recommended and is additional cost.
    Testing for Heartworm Disease is highly recommended and is additional cost.
    Testing for FeLV/FIV is highly recommended and is additional cost.
    E Collars are highly recommended to prevent licking or chewing on surgery sites/sutures. E Collars are provided at additional cost.
    Nail trims under sedation/anesthesia is at reduced stress for many animals. This is with additional cost.
    Microchips are the number one method of pet identification should you become separated. The microchip number is automatically entered in a national database and is a standard for identification. This service is at additional cost.
  • Please note here if you have any comments or special requests.
  • Date Format: MM slash DD slash YYYY
  • Sign with finger if mobile phone or tablet, drag mouse if PC or Mac.
  • This field is for validation purposes and should be left unchanged.