Surgery Consent Form

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Surgery Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 636-225-8387 for a faster response.

Name *

First

Last

Email *

Pet's Name *

Pet's Age *

Procedure Your Pet Is Receiving *

Anything else needed while pet is under anesthesia?

Emergency Phone Number *

While undergoing these procedures your pet will receive anesthetic drugs that prevent pain. Because we care about your pet’s comfort and strongly believe that pain relief is important, additional pain medications will be provided, as needed, to control the level of your pet’s discomfort after surgery and during its recovery.

I am the owner (or authorized agent of the owner) of the animal described above, and have the authority to execute this consent. I understand that some risk always exists with anesthesia, even in apparently healthy animals, including the possibility of death. I have discussed my concerns with the veterinarian and understand that it may be necessary to provide additional medical or surgical treatment to my pet in the event of unforeseen circumstances. I realize that no guarantee, legal or ethical, can be made to me regarding the outcome of any procedure performed. I hereby authorize the use of anesthetics and other medications, as well as any such additional treatment, as deemed necessary by the veterinarian. I understand that hospital personnel will be employed in treating my pet. I have carefully read, and fully understand, this consent. *

I have read and understand

The fees associated with these services have been explained to me, and I agree to pay such fees at the time my pet is released from the hospital. *

I have read and agree

Signature *

Clear Signature

Today's Date *

Surgery Consent Form

Surgery Consent Form

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