Surgery Form 3 Anesthesia Consent

Answers to the following questions are important to ensure your animal's safety and a smooth procedure.
  • Please provide a phone number(s) where you may be reached at ALL times while your pet is in our care.
  • Please state the procedure recommended to you by the veterinarian. Noting this incorrectly may cause delays. If you are unclear, please call (541)826-9001 and ask to speak to the veterinarian recommending the procedure.
  • 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.